





t 



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POLLARD AND MINKLER'S 

OBSTETRICAL SUPPORTER: 

A DESCRIPTION 

OF ITS 

APPLICATION, USE, & BENEFICIAL EFFECTS, 

AS CONNECTED WITH THE NATURAL PARTS AND ORGANS, 
IN THE 

mmmm m vmmmmm 

EMBRACING ALSO 

A DESCRIPTION OF THE MUSCLES CONCERNED IN THE 
MECHANISM OF LABOR. 

BY A. POLLARD, M. D. 



KEESEVILLE, N. Y. 

PRINTED BY JON. F.MORGAN: 
1849. 



f& 






By transfer frotn 
Pat. Office Ldfc. 

April i*l4. 



wtisjmwfflsm mrnmm 



I presume that under no circumstances what- 
ever could 1 have produced a work that would 
have carried the world along with it, nolens vo- 
lens ; that would require a depth of thought, a 
fund of knowledge, and a sparkling genius to 
which I make not the least pretension. Nor 
did I ever claim in my wildest boyish flights of 
day-dreams, amid the enchantments of a roman- 
tic scenery, or when lured on by the 'will-o'-the- 
wisp' to build castles in the air, that I possessed 
that peculiar kind of captivating or meteoric ge- 
nius that shoots athwart the literary and scien- 
tific horizon and leaves a splendid and luminous 
path behind it, to attract the astonished and ad- 
miring gaze of all our fellow-mortals, and, by 
sirenization, hold them fast against their judg- 
ment and their will, and by lighting up their 
foot-steps in a halo of enchanting effulgence, 



IV 



serve as a beacon to draw the world of mankind 
in my wake through weal or woe. However 
agreeable those charmed powers might be to 
him who could sway the universe thereby, and 
mould the minds, hearts and actions of his fel- 
low-men into a subserviency to his own views, 
and at all times control the turbulence of human 
passions and emotions, as the winds of heaven 
are held by the Power that created them, still I 
never could work myself into a belief that I pos- 
sessed them. 

I do think, however, that under a different 
state of things I might have told the simple 
facts and truths which I have endeavored to lay 
before the public, in a more pleasing if not in a 
more forcible manner. At least, I think I might 
have clothed them in a more graceful exterior ; 
but after all, truth is the real gem which we are 
all in pursuit of. 

While composing this little work, I have la- 
bored under almost every disadvantage that a 
man could and not be entirely deprived of his 
intellect. It is known to all who have made the 
experiment, that our mental faculties may almost 
as well be absent as to be divided among a 
thousand conflicting calls at one and the same 
time. In the first place, it is a kind of labor that I . 



have never been accustomed to perform. True, 
I have been in the habit of thinking to some ex- 
tent ; but I have not been in the habit of arran- 
ging my thoughts in a systematic form for the in- 
spection of my professional friends, or the com- 
munity at large. I have been somewhat distur- 
bed and embarrassed under the pressure of pe- 
cuniary matters, which has afflicted the business 
community of all this region of country more or 
less. My professional business, for the most 
part of the time, has been pressing and some- 
what urgent, and for a part of the time very 
much so ; and no hour in the twenty-four have 
1 been able to call my own. I have been com- 
pelled to write in my office of business, and 
nearly one-third part of the time some one has 
been talking to me ; and I was compelled to 
hear and answer, compose and write, in the best 
manner that I could under all these perplexing 
drawbacks, which were sometimes enough to 
discourage a person with a much firmer nerve 
than I possess. 

Now, that this pamphlet will contain errors, 
I have not the least doubt in the world. It 
would be passing strange if it did not That 
they will be numerous, I very much fear. — 
That many of these errors may be attributed to 

a2 



VI 



the causes above enumerated, I think will be 
acceded to by all ; but that this will satisfacto- 
rily account for all these errors, is a matter yet 
to be tried. 

Those who are disposed to criticise harshly 
(I shall not say those gentlemen in this supposi- 
tion) which is sometimes done without under- 
standing the embarrassments under which a 
work is got up, and sometimes without under- 
standing even the w r ork itself, will probably be 
that class of persons with whom no excuse, 
whether reasonable or unreasonable, will be 
available. With this class I have nothing to do : 
I leave them to plume themselves in all the glo- 
ry that they may acquire by an abuse or a de- 
traction of the merits (if merits it has) of this 
little pamphlet. But, I hope, at least, that the 
disadvantages under which I labored will be ta- 
ken into the account by my friends, when they 
pass upon the style, or give judgment on the ex- 
ecution of this seemingly small, but to me real- 
ly great undertaking. If there appears to be a 
lack of research to gather together the proper 
and fit materials for a public exhibition like this, 
or a want of perception to lay hold of, and ap- 
propriate to my use materials that are already 
in my reach ; or, if there is a lack of judgment 



VII 



to apply, or put together these materials, then, 
of course, these deficiencies must be attributed 
to other causes than those which I have men- 
tioned, and a part of them, at least, to a cause 
over which I have no control, and of course can • 
not be accountable for the errors that grow out 
of those deficiencies. 

The only excuse that I can offer of any ap- 
parent weight for my audacity in stepping out of 
my appropriate sphere of action, and for attempt- 
ing a thing of this kind, for which I was but poor- 
ly qualified, and which had ought to have been 
the work of more able hands, is simply this : — 
the apparent urgency in the matter seemed to 
impel me irresistibly along until I was fairly 
committed, and then 1 went on from mere des- 
peration. 

In this little pamphlet I have laid an instru- 
ment before the profession and the world that 
is new to them both. I have attempted to de- 
scribe it, together with the natural parts and or- 
gans which it is' designed to aid and assist — al- 
so its true mode of application, use and benefits, 
or beneficial effects on that portion of our race 
who are worthy of our sympathies, and who 
have long stood in need of more substantial aid 
from those who hold the reins and have the di- 



VIII 



rection of that science which pertains to the 
healing art. 

This instrument, being new to the profession, 
will probably, like all other new things, have its 
warm friends and strong advocates, and also its 
opposers and detracters. It has already some 
very ardent, able and talented friends in the lit- 
tle circle where it is known, who are willing to 
go all lengths to secure its introduction and to 
promote its use — believing, as they do, that it is 
a heaven-sent messenger to mitigate the suffer- 
ings ot the female portion of our race. Some of 
the brightest stars that radiate the honor of our 
profession, have given a decided and most un- 
equivocal judgment in its favor. 

On the other hand, it has met with its oppo- 
sers ; but they are comparatively very few, and 
always theoretical instead of practical men ; 
and, 1 say it in all truth and candor, they are al- 
most universally those who hold a far less ex- 
alted station in the profession and in the eyes 
of the world at large, than those who have given 
it a voluntary and hearty approval. And finally, 
the opposers are usually those whose opposition, 
to say the least of it, is not very alarming, and 
whose influence would be but triflingly flat- 
tering. Some, without even seeing the inst-ru- 



IX 



ment, or having its application or utility explain- 
ed to them, have cried out, "Humbug — hum- 
bug ! away with this impostor ! we wash our 
hands of all participation in this abominable 
counterfeit, that is about to be palmed off on 
community!" and, in this way, these guardians 
of the common weal rid their garments of all the 
sins that are incident to the introduction and use 
of this instrument. Pious souls ! what a relief 
it must be to them ! 

However, most of this kind of opposition ap- 
pears to arise from no real wickedness of heart, 
but more from a want of capacity or discrimina- 
ting powers to distinguish between a humbug 
and a reality : consequently, they put down ev- 
erything that their grandfathers and fathers have 
not used, to be a 'humbug,' as a matter of course. 
Others have apparently been actuated by a kind 
of selfish jealousy — a dislike to everything which 
they have not had a hand in producing ; and al- 
though they do not violently oppose, still they 
will turn a cold shoulder — put on a most tremen- 
dous wise look, and then remark that "It may 
be popular among the women, but that it prob- 
ably don't amount to much, after all." 

Strange as it may appear, an alarm has been 
taken at the srreat success of the instrument, 



and some have expressed a fear that it would 
be purchased by families, and by its aid they 
would be enabled to dispense with the assist- 
ance of the accoucheur, and in this way a great 
injury was about to be perpetrated on the pro- 
fession ; which is probably without the least 
foundation, unless the profession drive them in- 
to it. While others have no objections in par- 
ticular, but say that the labor of child-birth is a 
natural process, and that nature neither requires 
nor will she admit of any successful or real as- 
sistance, and that we have only to fold our arms 
and let the work go on. Of this objection I 
have only to remark in this place, that it is a 
doctrine that has been too long preached for the 
good of suffering humanity. I had supposed 
that none of these objections would have been 
raised ; and I am happy to say that, with a ve- 
ry large majority of the profession, and those de- 
cidedly the most eminent in the science and art 
of Obstetrics, have made no such objections. — 
So, in regard to numbers, the instrument has a 
very large preponderance in its favor; and in re- 
gard to weight of character, you might as well 
compare infinity with finite things. 

From the very earliest time when I had weigh- 
ed this matter in my own mind with care — from 



XI 



the conclusions which I then arrived at, even be- 
fore an instrument was constructed, I had al- 
most made up my mind that no such objections 
would be urged against it. The principle on 
which it would act beneficially, appeared to me 
to be so perfectly obvious, that 1 verily believed 
no one at all conversant with the science could 
fail for one moment to comprehend its whole 
utility. But my disappointment in these expec- 
tations convinced me of the real necessity for 
me to expose myself in this public manner, in 
order to explain away those objections, accor- 
ding to the best of my abilities under the cir- 
cumstances as well as to show the actual or 
positive benefits which must necessarily result 
from a right application and use of the instru- 
ment. And in making these explanations, and in 
showing these benefits, I have struck off into a 
path hitherto, as far as my knowledge ex- 
tends, untrodden by man. 

The philosophical views which I have advan- 
ced to sustain the positions I have taken in this 
matter, and the explanations given (as I believe 
in accordance with both science and philoso- 
phy) are sustained, if I have not misapprehend- 
ed my whole subject, by actual demonstrations 
w 7 hich cannot be controverted, together with the 



XII 



reasons why it is that the calls of nature or the 
instinct of the female demand the various parts 
of this instrument to support and to aid and as- 
sist the natural efforts which are put forth by 
the muscular system, both voluntary and organ- 
ic or involuntary. All these explanations are ori- 
ginal with me. I have always understood that 
these things were called for by the patient, so 
and so ; but the reason why she calls for them 
I have searched for in vain through all the med- 
ical lore from the days of Hippocrates down to 
the present time ; — o'er all this ocean of learn- 
ing and science my efforts have been attended 
with the same ill success as was the first adven- 
ture of Noah's dove. If those principles w r hich 
I have advanced to prove the efficacy and the 
certainty with which it will most efficiently aid 
the parturient female have ever been previously 
advanced by any one in or out of the profession, 
they certainly have not come to my knowledge, 
and of course I have derived no advantage 
from them. 

Some have objected to the instrument be- 
cause a patent is obtained for it. I am well 
aware that there is a strong objection generally 
to patent anything in the profession ; and as far 
as medicines are concerned, my prejudice is as 



XIII 



strong as any other man's. But with regard to 
the surgical or to the mechanical department of 
the profession, I think the case is somewhat dif- 
ferent. As respects this instrument, the idea ori- 
ginated with my partner, and he is not a mem- 
ber of the profession. 1 am sorry to deprive 
the profession of the honor, but duty compels 
me to do so; and it was only by an express a- 
greement that the instrument should be patent- 
ed that I obtained a right to participate in the 
matter at all. 

I do not say that I have been entirely idle in 
the master. After having the original idea sug- 
gested to me, I have used all the powers of 
mind and knowledge that I could command to 
adapt the instrument exactly to the wants of 
nature in those cases in which it is designed to 
assist. If I am correct, I have no doubt but I 
shall receive the cordial support, and be sustain- 
ed by all the profession whose good opinions are 
worth aspiring for. If I am in an error, of course 
it will be detected, and it will then share the 
fate of all other known errors, in the condemna- 
tion of all wise and good men. 

With these remarks I submit this whole mat- 
ter to the decision of that tribunal before whom 
it must be adjudged ; and most cheerfully do I 



XVI 



await the result, with a firm expectation that the 
verdict will be in favor of all I have claimed. I 
now ask a careful perusal of this little pamphlet : 
it will be a loss of but little time, at most ; and 
if I am all wrong, I think it due to me from my 
professional brethren to make a sacrifice of thi£ 
very small amount of time to set me right again. 



POLLARD AND MINKLER'S 



©oDsinsirBasMi gropssirisiB* 



In order to describe this Instrument in such a manner 
that the description may pay the reader for a perusal, and 
interest those most directly concerned in its operation, and 
also to give a clear and philosophical account of its benefi- 
cial effects, the natural parts which it aids and assists, the 
manner in which, and the reason why it does it — it 
appears to be be necessary to give a concise and somewhat 
minute description of the anatomy of the parts more imme- 
diately concerned in the mechanism of labor. 

This may appear superfluous, and with apart of the pro- 
fession it may be so, to some extent ; still I think it will be 
better understood by most if not all the profession, to have 
the anatomy of the parts most directly concerned in labor, 
given in a connected form and in the order in which they 
are brought into operation in the great and important work 
of child-birth. 

A descripticn of the Instrument in the abstract, or a su- 
perficial glance at the natural organs concerned in parturh 



16 OBSTETRICAL 

tion, would probably lead to more or less confusion in the 
mind of the reader, and most likely to an endless controver- 
sy, without any fixed or determinate principles by which 
the controversy might be brought to a close and the points 
of dispute settled, beyond a peradventure. Whereas, a 
description of the Instrument, its operation and effects, in 
connection with a full, fair and plain description of the 
muscles and organs with which it co-operates to benefit 
the female, will lay the principles of action of both the na- 
tural and artificial parts before the reader in so simple and 
comprehensive a manner, and mark out the way in so plain 
and straight-forward a direction, that it would seem to be 
unnecessary for a fool to err therein. And although I may 
take up a little time in the description of those muscles 
which are directly and indirectly concerned in the delivery 
of the female, so as to give their rise, insertion and ordina- 
ry use, I hope I shall be excused, from the fact that mos£ 
of the principles which I propose to advance on this part 
of the subject are original with me, and of course I wish to 
sustain them with all the strength and force of argument 
which I can bring to bear in their favor. 

An explanation of the parts, as well as the facts involved 
in this work, appears to be the more important from the 
fact, that in many instances where I have been conversing 
with my professional brethren about the Obstetrical Sup- 
porter, it has been with much difficulty that I could make 
them understand how the supporter could facilitate labor, 
although they could readily understand that it would miti- 
gate the sufferings very much. This, with many other cir- 
cumstances, led me to believe that a short explanation of 
all the various operations, together with the means by which 
they are produced, might not at all times be amiss, even 
among the sons of Esculapius. Another reason why I sub- 



SUPPORTER. 17 

mit my scribblings to the inspection and criticisraof m j 
superiors is, that those most directly benefited in all these 
operations of which we treat, and consequently those most 
deeply interested, do not belong to the profession ; and al- 
though they may not comprehend all the force of my rea- 
soning on the anatomical structure of the various parts 
concerned in the process of parturition, from the fact that 
they will be unacquainted with many of the terms which I 
am compelled to use, still the most of what I have to say 
they will understand perfectly well, and very much of it 
they will comprehend fiom sad experience. And I have no 
doubt but to many of the arguments which 1 shall make 
use of, they would add their unqualified testimony to the 
truth of the same ; and fhey may very naturally and very 
laudably have a curiosity, (not an idle one,) to know some- 
thing about the o aeration of an instrument that affords them 
so much he'p at a time when, of all others, they most need 
it. I shall endeavor to make myself understood by almost 
every person with an ordinary intellect, with the exception 
of my anatomical descriptions ; they, of course, must be 
given in anatomical language, and this will be familiar on- 
ly to those who are acquainted with that branch of our 
profession. 

I will first proceed to describe the rise, insertion, use 
and operation of the muscles concerned in the process of 
partuii ion. 

Those muscles most directly concerned in labor, are the 
abdominal and the real respiratory muscles ; but in order 
for these muscles to act with any effective force, or to ren- 
der anything like the aid which it was intended by the Al- 
mighty that they should do, there must be a fixed or firm 
foundation and a reliable starting-point for them to act up- 
on. Then, having laid our foundation on the primeval 

• b2 



18 OBSTETRICAL 

rocks, against whose mural fronts the winds and the waves 
may dash their furious blasts and surges in vain, a systematic 
description of all these operations would naturally commence 
with this foundation. When the abdominal muscles con- 
trast with sufficient force to make any essential expulsive 
stTort, they must necessarily pull hard upon the points to 
which the two extremities of the muscles are attached, and 
the tendency to move those points will be in proportion to 
the contractile power of the muscles. The amount of la- 
bor accomplished by these muscles will be in proportion to 
the contractile power of the muscles, and the firmness with 
which the points of attachment are fixed and mace immo- 
vable, 

It cannot but be obvious to any person, on a moment's 
reflection, that if the points of attachment or insertion of 
these muscles are allowed to move when the muscles con- 
tract on themselves and consequently pull upcn these 
points, that all the effective or expulsive power, or at least 
the greatest poition of it, that belongs to these muscles, is 
counteracted at once. 

The various parts and processes of the pelvis being the 
points in which these muscles have their rise or insertion, 
it becomes all-impoitant that the pelvis should be made 
stationary — that it should be safely anchored, and held so, 
with a cable of sufficient strength to resist the contractile 
power of the abdominal muscles, which are called into ac- 
tion to expel the contents of the prim& vies, or uterus. — 
This might be done by commencing at the feet, making 
them a basis of action for this part of our wcrk, and then 
ascend from point to point until we arrive at the one con- 
cerned directly in parturition ; but this would be a round- 
about way of coming at the real object of the whole opera- 
tion. If we commence at the feet, we must first plant the 



SUPPORTER* 19 

feet upon some firm or not easily movable platform, and 
they must be fixed in such a manner that they can be retained 
in that position, without inconvenience, for a length of time 
which they are required to serve that purpose. The feet 
then act as a basis for the work which is now undertaken : 
the leg, i. e., the tibia and the fibula, must be fixed on the 
foot by the co-operative contraction of the appropriate but 
usually antagcnistical muscles — then the thigh must be fix- 
ed on the leg in the same manner — then the pelvis on the 
thigh in the same way ; but as I before remarked, this mode 
complicates the operation, and at the same time renders it 
far less effective. As brevity combined with efficiency I 
believe is always desirable, I therefore propose to do this 
business in a shorter way ; and I have other, and I think 
more weighty reasons, aside from brevity and simplicity. 
The first is, I think I can do it altogether better, and in a 
more workmanlike manner : the next is, I wish to connect 
with it a helping hand, which I cannct do with any proba- 
bility of success if I commence with the feet as the basis 
of my operations. 

In the construction of our Obstetrical Supporter, I had 
two grand objects' in view : the first was, to facilitate the 
operation of parturition by every means that could be em- 
ployed with perfect safety to the mother and child ; and 
while weio-hins; this matter, and with a most intense study 
endeavoring to bring something out of chaos to aid me in 
my effort, the idea darted through my mind of the great im- 
portance of firmly fixing the two points of attachment of the 
abdominal muscles ; and from this time commenced the 
first favorable impression I entertained for the Supporter; 
and to this end, and fcr this purpose, I have endeavored to 
adapt one portion of it. 

The next object was to mitigate directly the sufferings of 



20 OBSTETRICAL 

parturient females, by every means that human invention 
could devise, or that God has placed within our reach. To 
accomplish the first of these designs, I found it to be indis- 
pensably necessary that the pel /is should be fixed with 
great firmness, for reasons that I have heretofore given ; 
and for the above named reasons, and others to be given 
more in detail hereafter, I have fixed my basis of opera- 
tions at the knees. 

In order to prove the correctness of my position, and 
also to demonstrate- beyond cavil of the skeptical that by 
commencing at this point all can be accomplished that 
could be done in any other way, (how much soever you 
might complicate the machinery,) I shall proceed to give 
the origin and insertion of the muscles belonging to this 
department of our machinery, (viz: ) those belonging to 
the thigh and the pelvis. 

The muscles on the outside of the pelvis, called muscles 
of the thigh, are composed of one layer before and three 
layers behind. The layer before consists of five muscles, 
two of which are usually described with another set. 

The Pectinalis — Arises, broad and fleshy, from the 
upper and anterior portion of the os pubis, immediately a- 
bove the foramen thyroideum. Inserted into the anteri- 
or and superior part of the linea aspera of the os femoris, a 
little below the trochanter minor, by a flat and short ten- 
don. Us^, to bring the thigh upwards and inwards, and to 
give it a degree of rotation outwards. 

The Triceps Adductor Femoris. — I believe, according 
to the best modern anatomists, that under this appellation 
are comprehended three distinct (or nearly so) muscles : 

1st. Adductor Longus Femoris — Arises, by a strong 
roundish tendon, from the upper and anterior part of the 
pubis and from the symphysis pubis on the inner side of 



SUPPORTER. 21 

the pectinalis. Inserted, tendinous, near the middle of the 
posterior portion of the linea aspera, being continued for 
some way down. 

2d. Adductor Brevis Femoris — -Arises, tendinous, from 
the os pubismear its joining with the opposite os pubis, be- 
low and behind the former. Inserted, tendinous and fleshy, 
into the inner and upper part of the linea aspera from a lit- 
tle below the trochanter minor to the beginning of the in- 
sertion of the adductor longus. 

3d. Adductor Magnus Femoris — Arises a little lower 
down than the former, near the symphysis pubis, tendinous 
and fleshy, from the tuberosity of the os ischium — the fi- 
bres there run outwards and downwards. Inserted into al- 
most the whole length of the linea aspera and into a ridge 
above the internal condyle. 

Use of these three muscles or triceps to bring the thigh 
inwards and upwards according to the different directions 
of their fibres, and to some extent to roll the thigh outwards. 

The Obturator Externus — Arises, fleshy, from the low- 
er part of the os pubis and fore part of the inner crus of the 
ischium, surrounds the foramen thyroideum — a number of 
its fibres arising from the membranes that fill up that for- 
amen, and are collected like rays towards a centre and pass 
outwards around the root of the back part of the cervix of 
the os femoris. Inserted by a strong tendon into the cavity 
of the inner and back part of the root of the trochanter 
major, adhering in its course more or less to the capsular 
ligament of the thigh bone. Use, to roll the thigh bone 
obliquely outwards, and to prevent the capsular ligament 
from being pinched in the joint. 

Behind are, 1st. The Gluteus Maximus — Arises, fleshy, 
from the posterior part of the spine of the os illium, a little 
higher up than the joining of the ilium with the os sa- 



22 OBSTETRICAL 

erum, from the whole external side of the os sacrum below 
the posterior spinous process of the os ilium, from the pos- 
terior sacD-isciatic ligament and from the os coccygis. — 
All the fleshy fibres run obliquely forwards and a little 
downwards to form a very thick broad muscle, which is di- 
vided into a number of strong fasciculi. Inserted, by a 
strong thick and broad tendon, into the upper and outer 
part of the linea aspera, which is continued from the tro- 
chanter major for some way downwards as far as the ori- 
gin of the short head of the biceps flexor cruris, and also in- 
to the fascia femoris. Use, to extend the thigh by pulling 
it directly backwards and a little outwards. 

2d. Gluteus Medius — Arises, fleshy, from the ante- 
rior superior spinous process of the os ilium, and from the 
outer edge of the spine of the ilium, except its posterior 
part, where it arises from the dorsum of that bone. In- 
serted, by a broad tendon, into the outer and upper margin 
of the trochanter major. Use, to draw the thigh bone out- 
wards and a little backwards, to roll the thigh bone out- 
wards, especially when it is bended. 

The third layer consists of four muscles : 

1st. The Gluteus Minimus — Arises, fleshy, from a ridge 
that is continued from the superior anterior spinous process 
of the os ilium, and from the middle of the dorsum of that 
bone as far back as its great niche. Inserted, by a strong 
tendon, into the anterior and superior part of the trochanter 
major. Use, to assist the former in pulling the thigh out- 
wards and backwards and rolling it. 

2d. Pyriformis— Arises v,ithin the pelvis by three ten- 
dincus and fleshy origins from the second, third and fourth 
pieces of the os sacrum, from thence growing gradually 
narrower, it passes out of the pelvis below the niche in the 
posterior part of the os ilium, where it receives a few r fleshy 



SUPPORTER, .23 

fibres. Inserted, by a roundish tendon,intothe upper part 
of the cavity of the inner side of the root of the trochanter 
major. Use, to move the thigh a little upwards and roll 
it outwards. 

3d. Gemelli — Arise by two distinct origins, the superior 
from the spinous process, and the inferior from the tuber- 
osity of the os ischium, also from the posterior sacro-isci- 
atic ligament. Inserted into the cavity of the inner side of 
the root of the trochanter major, on each side of the tendon 
of the obturator internus, to which they firmly adhere. — 
Use, to roll the thigh outwards and to preserve the tendon 
of the obturator internus from being injured by the hardness 
of that part of the os ischium over which it passes ; also, 
to hinder it from starting out of its place while the muscle 
is in action. 

4<th. Quadrattjs'Femoris — Arises, tendinous and fleshy, 
from the outside of the tuberosity of the os ischium, and 
running transversly, is inserted, fleshy, into the rough 
line continued from the root of the large trochanter to the 
root of the small one. Use, to roll the thigh outwards. 

Next in order in this description will come those muscles 
situated on the thigh. They have sometimes been called 
muscles of the leg. They consist of one on the outside, 
two on the inside : four before and four behind. 

These muscles also have their origin from some parts of 
the pelvis, and are inserted into the thigh bone near the 
knee, or into the head of the fibula at or a little below the 
knee. On the outside is 

The Tensor Vaginae Femoris — Arises, by a tendinous 
and fleshy beginning, from the external part of the anterior 
superior spinous process of the os ilium Inserted a little 
below the trochanter major into the inner side of the mem- 
branous fascia, which covers the outside of the thigh* — 



24 OBSTETRICAL 

Use, to stretch the membranous fascia, to assist in the ad- 
duction of the thigh, and somewhat in the rotation in- 
wards. 

On the inside are, 1st. The Sartorius — Arises, tendinous, 
from the anterior superior spinous process of the os ilium, 
soon becomes fleshy, runs down for some Sj;ace on the rec- 
tus, and going obliquely inwards it passes over the vastus 
internus, and at about the middle of the os femoris over a 
part of the triceps, it runs further between the tendon of 
adductor magnus and that of the gracilis muscles. Insert- 
ed, by a broad and thin tendon, into the inner side of the 
tibia, near the inferior part of the tubercle. Use, to bend 
the leg obliquely inwards, or to bring one leg across the 
other. 

2d The Gracilis — Arises, by a thin tendon, from the 
os pubis, near the symphysis of these two bones ; soon 
grows fleshy and descends by the inside of the thigh. Is in- 
serted, tendinous, into the tibia under sartorius. Use, to 
assist the sartorius. 

Before are, 1st. The Rectus — Arises, fleshy, from the an- 
terior inferior spinous process of the os ilium, and, tendinous, 
from the dorsum of the ilium, a little above the acetabu- 
lum. Inserted, tendinous, into the upper part of the patella, 
from which a thin tendon runs down on the forepart of this 
bone to terminate in a thick strong ligament which is sent 
off from the inferior part of the patella and inserted into the 
tubercle of the tibia. Use, to extend the leg, and in a 
powerful manner, by the intervention of the patella, acting 
like a pully. 

2d. Semitendinostts — Arises, tendinous and fleshy, in 
common with the long head of the triceps, from the poste- 
rior part of the tuberosity of the os ischium, and sending 
down a long roundish tendon which ends fiat, is inserted 



SUPPORTER. 25 

into the inside of the ridge of the tibia, a little below its 
tubercle. Use, to bend the leg backwards and a little 
inwards. 

3d. Semimembranosus — Arises, tendinous, from the up- 
per and posterior part of the tuberosity of the os ischium, 
sends down a broad flat tendon, which ends in a fleshy bel- 
ly, and in its descent runs first on the forepart of the tri- 
ceps, and, still lower, between it and thesernitendinosus. — < 
Inserted,tendinous, into the inner and back part of the head 
of the tibia. Use, to bend the leg and bring it directly 
backwards. 

The two last muscles form what is called the inner ham- 
string. 

4th. Biceps Flexor Cruris. — Arises by two distinct 
heads. The first, called the longus, arises in common with 
the semitendinosus from the posterior superior part of the 
tuberosity ot the os ischium. 

The second, called brevis, arises from the linea aspera, 
a little below the termination of the gluteus maximus, by an 
acute fleshy beginning, which soon grows broader as it de- 
scends to join withthe first head a little above the external 
condyle of the os femoris. Inserted, by a strong tendon , 
into the superior part of the head of the fibula. Use, tc 
bend the leg. 

The tendon of this muscle forms what in vernacular lan- 
guage is called the outer ham-string. 

5th. The Psoas Magnus — Arises, fleshy, from the side 
of the body and transverse process of the last dorsal verte- 
bra, and in like manner from those of the loins, by as many 
distinct slips. 

On this muscle are situated two aponeurotic arches, call- 
ed ligamentum arcuatum internus and ligamentum arena- 
turn externus. The former has an attachment on the one 



26 OBSTETRICAL 

hand to the points of the transverse processes, and on the 
other to the bodies of the upper lumber vertebra. The 
latter passes from the anterior extremity of the former to 
the inferior margin of the last rib, embracing in its curve 
below the quadratus lumborum muscle. 

The superior position or margin of both these arches 
give origin to a set of fibres which unite with the lesser 
muscle of the diaphragm, and serve to cut off more effect- 
ually any communication between the thorasic and abdom- 
inal cavities. Inserted, tendinous into the trochanter mi- 
nor of the os femoris, and fleshy into that bone, a little be- 
low the same trochanter. Use, to bend, the thtgh forwards, 
or when the inferior extremity is fixed, it bends the body 
forwards. 

It will be seen that the psoas magnus muscle is not di-* 
rectly connected with the pelvis independent of any other 
muscle, but a description of it is given on account of the 
important part which it acts by its direct and intimate con- 
nection with the lesser muscle of the diapragm, and the 
manner in which it assists in forming the plain of the 
diaphragm, between which and that formed by the ab- 
dominal muscles the contents of the uterus are expelled,, 
of this we shall say more hereafter. 

There are also other connections which it has by a union 
of muscular fibres with the iliacus as they pass over the os 
pubis together, which renders it quite important in holding 
the pelvis ; so much so, that it seemed to be necessary to 
give a discription of it, and it has been described by some 
anatomists in connection with the iliacus internus, as being 
a biceps, or double headed muscle. 

We will now proceed to describe the two muscles, of 
which I remarked at the commencement of this descrip- 
tion that I should describe them 'in another place. They 



SUPPORTER, 27 

a?e muscles of the thigh and pelvis, but they are more in- 
timately connected with those which I have been descri- 
bing in this place, than they are with those with which they 
are classed. They are 

The Iliacus Internus— Arises, fleshy, from the trans- 
verse process of the last vertebra of the loins, from all the 
inner lip of the spine of the os ilium, from the edge of that 
bone, between its anterior spinous process and the aceta- 
bulum, and from most of the concave portion of the os ili- 
um, it joins with the psoas magnus where it passes over 
the pubis by an interlacing of muscular fibres ; it then be- 
gins to become tendinous, and is inserted, along with the 
psoas, into the trochanter minor. Use, to assist the psoas 
in bending the thigh, and to bring it directly forwards. 

The Obturator Inter nus— Arises from more than half 
the internal circumference of the foramen thyroideum, for- 
med by the os pubis and the.os ischium, and from the su- 
perior part of that portion of the ischium where it joins 
the ilium. It forms, in union with some fibres from anoth- 
er, a roundish tendon that passes out of the pelvis between 
the posterior sacro-isciatic ligament and the tuberosity Gf 
the os ischium. Inserted, by a round tendcD,into the large 
pit at the root of the trochanter major. Use ; to roll the 
os femoris obliquely outwards. 

Acting at the same time with those muscles already des- 
cribed, but somewhat antagonistically, or in nearly oppo- 
site directions, are two muscles which pass from the poste- 
rior portions of the pelvis to the lower ribs, the lower ver- 
tabra of the back and the vertebrse of the loins. These 
muscles contract in unison with the abdominal mus- 
cles, in labor, and in nearly the same direction. They 
are most particularly useful in their action, by holding firm- 
ly tha posterior and inferior portions of the pelvis while the 



28 OBSTETRICAL 

abdominal muscles contract, with great force, on the ante- 
rior parts of it ; and these two powers acting at the same 
time and in the same directions, maintain an equilibrium of 
action which could not be maintained without them. At 
the same time, they add very much to the stability of the 
pelvis during labor, particularly if the patient is so situated 
that these muscles can contract, as they were originally 
designed to do. 

These muscles are — 1st, Quadratus Lumborum — Arises, 
broad, tendinous and fleshy, from the posterior part of the 
spine of the os ilium. Inserted into the transverse processes 
of all the vertebrae of the loins, also into the last rib near 
the spine, and by a small tendon into the side of the last 
dorsal vertebra. Use, to move the loins to one side, to pull 
down the last rib, and, when both act together, to bend 
the loins. 

2d, The Psoas Parvus — Arises, fleshy, from the sides of 
the superior vertebrae of the loins, and sends off a tendon 
of considerable length, which ends thin and broad, and is 
inserted into the brim of the pelvis, near the junction of 
the os ilium with the os pubis. Use, to assist the psoas 
magnus in bending the loins and holding the pelvis. 

Thus it may be seen, by taking a glance over the rise and 
insertion of the muscles which I have described, that they 
all arise from some part of the pelvis, i. e., from the ilium, 
ischium, sacrum or pubis, or from the spines, crests, rami, 
tuberosities or other processes of the same — except the short 
head of the biceps flexor cruris, which very soon unites 
with the other, so that all the power of ths muscle is made 
to bear on the tuberosity of the os ischium, and the psoas 
magnus — the importance of that and the manner in which it 
connects itself with those muscles that act directly upon 
the pelvis, I have already commented upon sufficient^ 



StfPPORTEft. 29 

A Careful view of this subject will also show to the read- 
er that here are quite a number, and most of them very 
powerful muscles, that have their origin or insertion from 
or in some pait of the pelvis, and that the lower extremity 
of all these muscles is either above, at, or a little below the 
knee joint, consequently it is most easy to see the fallacy 
of going below the knee for a platform or support as a ba- 
sis of action for these muscles. Whenever we go below 
the knee for a basis of action for the above described mus- 
cles, we are compelled to call into action another set of 
muscles which are quite numerous, and which have no 
necessary connection whatever with them, in order to per- 
form the work for which we make use of the others, and 
are also entirely independent of them as far as the work 
is concerned which we assign them in connexion with the 
Obstetrical Supporter ; and bringing in this useless lumber, 
would render it much more tiresome, and far less effective 
for the patient. The place of support to obtain the most 
effective action of these muscles, is instinctively indicated 
to the parturient female, hence it is that she will always 
desire to have her knees held firmly during the active stage 
of parturition, although she knows not the philosophical 
reason why this desire is so urgent, nor have I myself ever 
before seen an attempt at an explanation of ih 

It appears then that the great and important function of 
these muscles is to hold the pelvis with great firmness in 
all its parts, in such a manner that the strong contractile 
power of the abdominal muscles to expel the contents of 
the uterus, in the act of parturition, shall not cause the pel- 
vis to vacillate or turn in any direction, which would seri- 
ously impair the effective action and contractile power of 
the abdominal muscles. 

In order to make the knees the basis of action for the 

c2 



30 OBSTETRICAL 

muscles which I have described, while performing the work 
I have allotted them, I propose to plant them firmly in the 
loops of the main straps of the Obstetrical Supporter. 

These loops contain sliding pads, so that the knee can 
always be placed directly upon them, not only holding them 
with great firmness, but also with perfect ease to the pa- 
tient^ however protracted the labor may be. 

These muscles, in the order in which I have described 
them, have separate functions to perform; and in these va- 
rious functions act independently or antagonistically, ac- 
cording as the power of the will is brought to bear upon 
them. But when the knee is firmly fixed in the loop of 
the Obstretiieal Supporter, an effort is made to extend the 
thighs on the pelvis ; this effort being stoutly resisted and 
held fast by the Supporter, there is a simultaneous action of 
all these muscles together, consentrated upon one purpose ; 
and although their separate actions as flexors, extensors, 
abductors, adductors, rotators, &c, might not be so great, 
still when they all act together, and their combined action 
is exerted to accomplish one object, it is easy to see that 
their power must be immense. 

By an inherent principle, or the stimulus of the will, 
these muscles contract on themselves, pulling with great 
force on the point of attachment of each extremity ; of 
course they will then pull upon each point of the pelvis to 
which they are attached. This attachment being on all 
the depending portions of the pelvis, they must necessarily 
hold it firmly and steadily when the abdominal muscles, 
which are attached to the superior portion of it, exert th eir 
powers upon it. 

Having formed, as we believe, a solid foundation for the 
lower portion of the abdominal muscles to wo.k upon, we 



SUPPORTER. 31 

will turn our attention to their origin, or the attachment of 
their superior extremities. 

It is equally necessary that this should be a firmly fixed 
point, as it is that the point of attachment for the lower ex- 
tremity of the muscles should be so, And although the 
means of doing this is instinctively indicated to the partu- 
rient female, still like the case of the lower extremities, I 
have never heard it explained, or an explanation attempt- 
ed ; and in order to delineate the philosophical operation, 
it will be necessary to turn again to the muscles, and work 
it out on that great chess-board of nature. 

As the abdominal muscles have either their rise or in- 
sertion from or into the sternum and its cartilages, from 
the ribs or their cartilaginous extremities, it will be obvi- 
ously necessary to fix these points, otherwise what we gain 
by the fixture of the pelvis we loose by the absence of an 
equal support for the superior extremity of those muscles. 
In laying out this work of making a fixed point of the ribs 
and sternum, we will commence with the muscles situated 
• on the anterior part of the thorax : 

These? nay be divided into two layers, the first layer 
consisting of one muscle : 

The Pectoralis Major — Arises from the cartilagin- 
ous extremi.ias of the fifth and sixth ribs, where it usually 
mixes and intermixes with the external oblique muscle of 
the abdomen, from about the whole length of the sternum, 
and from near half of the anterior part of the clavical ; the 
fibres then turn towards the axilla, in a folded manner. — 
Inserted, by two broad tendons, which cross each other at 
the upper and inner part of the os humeri, above the [in- 
sertion of the deltoid muscle and outer side of the oroove 
for holding the tendon of the longhead of the biceps. — 



32 OBSTETRICAL 

Use, to move the arm forwards and obliquely upwards to- 
wards the sternum. 

The second layer consists of three muscles : 

1st, The Subclavius — Arises from the cartilage that joins 
the first rib to the sternum. Inserted, after becoming 
fleshy, into the inferior part of the clavical, which it occu- 
pies to within an inch of the sternum, as far outwards as 
its connection by ligament with the coracoid process of the 
scapula. Use, to pull the clavical. 

2d, The Pectoralis Minor — Arises, tendinous and 
fleshy, from the upper edge of the third, fourth and fifth 
ribs, near where ihey join with their cartilages. Inserted, 
tendinous, into the coracoid process of the scapula. Use, to 
bring the scapula forwards and downwards, and to raise the 
ribs upwards. * 

3d, The Serratus Magnus — Arises from the nine su- 
perior ribs, by an equal number of fleshy digitations, resem- 
bling the teeth of a saw. Inserted, fleshy, into the whole 
base of the scapula, internally, between the insertion of 
the romboid and the origin of the subscapularis muscle, 
being folded about the two angles of the scapula. Use, to 
move the scapula forwards, and when the scapula is forci- 
bly raised, to draw upwards the ribs. The muscles within 
th-3 thorax form one pair. 

The Triangularis, or Sternocostal^— -Arises, fleshy, 
and a little tendinous, from all the length of the cariilao-o 
ensiformis, laterally, and from the edge of the lower half 
of the middle bone of the sternum, from whence its fibres 
ascend obliquely upwards and outwards. Inserted, by 
three triangular terminations, into the lower edge of the 
cartilages' of the third fourth and fifth ribs, near the union of 
the cartilages with the ribs. Use, to depress the car- 



SUPPORTER. 33 

tilages and the extremities, and consequently to assist in 
contracting the cavity of the thorax. 

The muscles situated between the ribs, the intercos- 
talis exerni and the intercostalis interni, I have omitted, 
although they perform quite an important part in this work, 
by their assistance to raise the ribs, and to secure and main- 
tain a uniformity of action between all the ribs ; so that 
when a muscle operates to hold one of the ribs, through 
the medium of the operation of these muscles, they would 
all be held by the same power, being firmly bound together 
by the intercostal muscles. As those muscles which we 
design to hold the ribs, connect the ribs and the scapula, 
and as the scapula must act in this situation as a basis for 
these muscles, and as the scapula is naturally a movable 
body, and that to a very great extent, it now becomes 
necessary to devise some means by which we may hold it 
with sufficient power to have it serve our purpose. 

We will now take up the muscles situated on the poste- 
rior part of the trunk. These are usually divided into four 
layers and a single-pair. 

The first layer consists of a single pair of tremendous 
power ; they cover almost the whole posterior part of the 
trunk, and I think they are the most perfect and beautiful 
pair of muscles in the whole human system. The single 
muscle is called, 

The Trapesius, or Cucularis — Arises, by a strong 
round tendon, from the lower part of the protuberance in 
the middle of the os occippitis, behind, and by their membra- 
nous tendon, from the rough curved line that extends from 
the protuberance towards the mastoid process of the tem- 
poral bone ; runs down along the nape of the neck, where it 
seems to arise from its fellow, and covers the spinous pro- 
cesses of the superior vertebrae of the neck ; it also arises 



34 OBSTETRICAL 

from the spinous processes of the two inferior servical ver- 
tebrae, and from the spinous processes of all the dorsal ver- 
tebrae, adhering by an interweaving of tendinous fibres to 
its fellow, the entire length of its origin. The junction of 
those tendons forms a sort of eliptical expansion on the back 
of the neck. Inserted, fleshy, into the posterior half of the 
clavicle, tendinous and fleshy, into the acromion, and into 
almost all the spine of the scapula. Use, it moves the sca- 
pula according to the three different directions of its fibres ; 
for the upper descending fibres draw it upwards and some- 
what obliquely backwards, the middle transverse straight 
fibres draw it directly backwards, and the inferior ascend- 
ing fibres draw it obliquely downwards and backwards. 

The two trapesii, taken together, have some resemblance 
to the monks' cowl, hanging over the neck ; hence the 
name of cucularis is sometimes given to them. When the 
trapesius is dissected on both sides, the two muscles rep- 
resent a trapesium, or diamond shaped quadrangle on the 
back of the shoulders. 

2d. The Latissimus Dorsi — Arises, by a broad thin ten- 
don, from the posterior part of the spine of the os ilium, 
from all the spinous processes of the os sacrum, and verte- 
brae of the loins, and from the seven inferior ones of the 
vertebrae of the back ; also, tendinous and fleshy, from 
the extremeties of the three or four inferior ribs, a little be- 
yond the cartilages, by as many distinct slips — the inferior 
fibres ascend obliquely, and the superior run transversly 
over the inferior angle of the scapula towards the axilla, 
where they are collected, twisted and folded ; and here 
some additional fibres of the muscle have their origin, from 
the superior angle of the scapula. Inserted, by a strong 
thin tendon, into the inner edge of the groove for lodging the 
tendon of the long head of the biceps flexor cubiti. Use, 



SUPPORTER. 35 

to pull the arm backwards and downwards, and to roll the 
numerous. 

On the back we have two muscles, or one divided into 
two portions, wb'chwe must press into our service. When 
spoken of as one muscle, it is called the Rhomboideus. 

1st, The Rhomboideus Major — Arises, tendinous, from 
the spinous processes of the five superior dorsal vertebrae. 
Inserted into all the base of the scapula, below its spine. — 
Use, to draw the scapula obliquely upwards and directly 
inwards. 

2d. The Rhomboideus Minor — Arises, tendinous, from 
the spinous processes of the three inferior vertebrae of the 
neck, and from the ligamentum nuchse. Inserted into 
the base of the scapula, opposite to its spine. Use, to as- 
sist the former. 

Levater Scapulae — Arises, tendinous and fleshy, from 
the transverse processes of the five uppermost vertebrae of 
the neck by as many distinct slips, which soon unite to form 
a muscle that runs downwards and outwards. Insert ed 7 
fleshy, into the superior angle of the scapula. Use, to pull 
the scapula upwards, and a little forwards. 

It will now readily be seen that when the last described 
muscles act antagonistically, and in conjunction with those 
of the anterior part of the thorax, that they will fix the 
scapula with great firmness in a superior posterior and infe- 
rior direction ; and I believe these are cables and anchors 
that will hold against the opposition of almost any terrific 
storm, however great may be its violence. 

We will now see it we can fix the scapula anteriorly. If 
we succeed in doing so, it will answer our purpose very 
well. We will now turn our attention to the muscles that 
pass from the scapula to the arm or os humeri. They are : 

1st. Supra Spinatus — Arises, fleshy, from all that part 



36 OBSTETRICAL 

of the base of the scapula that is above its spine, also, 
from the spine*and superior costa ; passes under the acromi- 
on, and adheres to the capsular ligament of the os humeri. 
Inserted, tendinous, into that part of the large protuber- 
ance on the head of the os humeri that is next the groove 
For lodging the tendon of the long head of the biceps. — 
Use, to raise the arm upwards. 

2d. The Infra Spinatus — Arises, fleshy, from all that 
part of the base of the scapula that is between its spine 
and inferior angle, and from the spine as far as the cervix 
of the scapulae The fibres ascend and descend obliquely 
towards the tendon in the middle of the muscle which runs 
forwards and adheres to the capsular ligament. Inserted, 
by a thick short tendon, into the upper and middle part of 
the large protuberance on the head of the os humeri. Use, 
to roll the numerous outwards, and to assist to raise and 
support it when raised. 

3d. The Teres Minor — Arises, fleshy, from all the 
.round edge of the inferior costa of the scapula, and runs 
forward along the inferior edge of the infra-spinatus, and 
adheres to the ligament. Inserted, tendinous, into the 
back part of the large protuberance on the head of the os 
humeri, a little behind and below the termination of the 
last named muscle. Use, to roll the numerous outwards, 
and to draw it backwards. 

4. The Teres Major — Arises, fleshy, from the inferior 
angle of the scapula, and from all that portion of its inferior 
costa that is rough and thicker than the rest ; its fleshy fi- 
bres are continued over part of the infra-spinatus muscle, to 
which they firmly adhere* Inserted, by a broad, short and 
thin tendon, into the ridge at the inner side of the groove 
for lodging the tendon cf the long head of the biceps flexor 
cubiti, along with the latisimus dorsi. Use, to roll the hu- 



SUPPORTER* 37 

merous inwards, and to draw it backwards and downwards 

The two muscles before the scapula are : 

1st. The Deltoides — Arises, fleshy, from all the poste- 
rior part of the clavicle that the pectoralis major does not 
occupy, tendinous and fleshy, from the acromion and inferi- 
or margin of almost the whole spine of the scapula, oppo- 
site to the insertion of the cucularis muscle ; from thess 
origins it runs m three different directions, i. e., from the 
clavicle downwards and outwards, from the spine of the 
scapula outwards, forwards and downwards, and from the 
acromion straight downwards, and is composed of a number 
of fasciculi which form a strong fleshy muscle that covers 
the anterior part of the joint of the 03 humeri. Inserted, 
tendinous, into a rough protuberance in the outer side of 
the os humeri, near its middle, where the fibres of this mus- 
cle intermix with some part of the brachialis externum 
muscle. Use, to pull the. arm directly outwards and up- 
wards, and a little forwards and backward, according to the 
directions of its fibres, and when they all act together they 
pull the arm forward?. 

2d. The Coraco Brachialis — Arises, tendinous and. 
fleshy, from the forepart of the coracoid process of the 
scapula, adhering in its descent to the short head of the 
biceps. Inserted, tendinous and fleshy, into near the cen- 
tre of the internal part of the os humeri. Use, to carry the 
arm forwards and a little upwards. 

The Stjbscapularis — Arises, fleshy, from all the base of 
the scapula internally, and from the superior and inferior 
costce, being composed of a number of tendinous and fleshy 
fosciculi which leave prints on the bone : they all join to- 
gether and fill up the hollow of the scapula, and pass over 
the joint adhering to the capsular ligament. Inserted, ten- 
dinous, into the upper part of the protuberance on the in- 

D 



II OBSTETRICAL 

net side of the head of the os humeri. Use, to roll trW 
humorous inwards and to draw it to the side of the body. 

The Biceps Flexor Cubiti — Arises by two heads, as 
Ihe name indicates. The first, or outermost, called longus, 
begins, tendinous, from the upper edge of the glenoid cavi- 
ty of the scapula, passes over the bead of the ©^burners 
within the joint, and in its descent, without the joint, is in- 
closed in a groove near the head of the os humeri oy a 
membranous ligament that proceeds from the capsular liga- 
ment asrid the adjacent tendons. 

The second, or innermost head, called brevis, arises, ten- 
dinous and fleshy, from the coracoid process of the scapula, 
in common w r ith the coraco-brachialis muscle. A little be- 
low the mMdte of the fore part of the os humeri these heads- 
unite and are inserted into the tubercle on the upper end 
of the radius by a strong roundish tendon. Use, to turn 
the hand supine and to bend the fore arm. 

At the banding of the fore arm or elbow, where it begins 
to grow tendinous, it sends off an aponeurosis, which covers 
ail the muscles on the inside of the fore arm and joins with 
another tendinous membrane which is sent ciF from the tri- 
ceps extensor cubiti, which covers all the muscles on the 
outside of the fore arm, and a number of the fibres from ihs 
opposite sides decssuate each other. It serves to strength- 
en the muscles very much by keeping them from swelling 
too much outwardly w^hen in action or strongly contracted. 

The Triceps Extensor Cubiti— Arises by three heads, 
the first called longus, somewhat broad and tendinous from 
the inferior costa of the scapula near its cervix. The second 
head, called brevis, arises by an acute tendinous and fleshy 
beginning from the back part of the os humeri, a little be- 
low its head on the outer part. The third head, called bra- 
chials externus, "arises by an acute beginning from ite 



SUPPORTER. 39 

t)ack part of the os humeri* These three heads unite a lit- 
tle lower than the insertion of the teres major and cover 
the whole posterior part of the numerous. Inserted into 
the upper and external part of the process of the ulna, call- 
ed olecranon, and partly into the condyles of the 03 humeri. 
Use, to extend the fore arm, 

I think it will require no telescope, or other optical in- 
strument save that of an ordinary perception, to discver that 
when these muscles act conjointly and contract on them- 
selves, that, from their attachment to the various processes 
of the scapula, they will hold it with a firmness and a power 
siot easily overcome by any antagonistic or opposing pow- 
er. It will be seen by a bird's-eye view of the description 
;$f these muscles, that they have their origin from the vari- 
ous points and angles of the scapula, and that they all pass 
in a forward direction, to be inserted into various portions 
of the bone of the arm, and in a few instances into those of 
the fore arm. Hence it will follow as as a matter of neces- 
sity, that in order for these muscles to perform the work 
that I have marked out for them, viz : t© hold the scapula 
and make a fixed point of the same, it wiil be necessary for 
them to have a fixed paint or basis of action, anterior to 
the direction of their fibres : this we shall see to hereafter, 
as we continue to put together the w 7 heelvvork of our ma- 
chinery. 

This set of muscles, if we make them work agreeably to 
our expectations, we think will complete the circle which 
we left unfinished in our previous description, and will 
make the scapula a fixed centre of motion for the various 
agents which we shall hereafter require to move upon it. 

This beiag settled, we turn to the anterior basis of ac- 
tion, and for this we shall make use of the hands. We 
cannot, as at the inferior extremities, fix our basis of action 



40 OBSTETRIC^ 

at the distal ends of the mus2les that we call into actiofi iri 
labor — therefore, not having the choice as in the other case,- 
we take the next most convenient point. But in this case 
we have nothing to loose, except in the employment of a 
set of muscles that do not directly belong to the work ; 
while, in the case of the lower extremities, if we go below 
the knees we lose nearly all the benefits of the back pad ; 
and that we are correct in using the hands as a basis of ac- 
tion in the upper extremities, we have the evidence of the 
instinctive or natural calls of the parturient female herself 
For this purpose the hands must grasp firmly upon some 
fixed point — then put the muscles that pass from the fore 
arm to the hand upon the stretch, which will fix the fore 
arm on the hand. Then the muscles passing from the arm 
to the forearm will contract on themselves and fix the arm 
on the forearm. Then the muscles passing from the ante- 
rior points and angles of the scapula, running forwards and 
inserted into the arm, being those mentioned in i the last de- 
scription, will contract strongly and firmly on themselves^ 
and, of course, will pull hard on each point of attachment 
and the necessary result will be that they will fix the sca- 
pula on the arm, in an anterior direction, with an unshaken 
stability. When these muscles contract, they will have a 
tendency to pull the scapula downwapds, or forwards and 
downwards. This will excite those muscles that I have 
described as having their attachment to the posterior and 
superior portions of the scapula, and they will contract 
firmly, and by the strength of their contractile power they 
will fix the scapula with a reliable constancy between 
these strongly-exerted antagonistical powers. Under these 
circumstances, we can lay hold of it from another direction, 
with great reliance upon the stability with which it is fix- 
ed in that situation. 



SUPPORTER, 41 

Now when the superior extremity of the abdominal mus- 
cles, which are attached to the sternum, cartilages and ribs, 
contract with a force to draw them downwards, they will 
excite to action the muscles which we have described on 
the anterior and inferior part of the trunk, which it will be 
recollected are attached to the ribs and sternum inferiorly, 
and to the scapula and clavicle superiorly ; and when these 
contract with a tendency to pull upon the scapula, it will 
excite still more to contraction the levators scapulas and 
the superior fibres of the trapesius, which will fix the sca- 
pula with more stability. The scapula now being a firmly 
fixed point, these muscles may pull upon it with perfect 
impunity. 

The opposite extremities of these muscles being attach- 
ed to the ribs, cartilages and sternum, it is very evident 
that when they contract firmly on the scapula they will 
hold the ribs and sternum .to the extent of their contractile 
power. Thus we have fixed both the points on which the 
abdominal muscles contract to expel the contents of the 
uterus in the act of child-birth, and hence it is that parturi- 
ent females express an urgent desire, instinctively indicated 
to them, as I have before remarked, to pull with their 
hands more or less, or to grasp something with the hands, 
so as to fix that chain of muscles which I have described ; 
and now, the reason appears so obvious, that a tyro ought 
not to mistake the indications. 

These wants we think we have amply provided for in 
the Obstetrical Supporter, by placing two handles within 
the reach of the patient, well fitted to the hand, and cover- 
ed with velvet so that the patient may grasp them firmly 
and with perfect ease to herself. 

These handles are made fast by an attachment to each 
end of a strap that passes through the loops and over the 

d2 



42 OBSTETRICAL 

movable knee pads, so that the patient may pull on them 
as hard or as lightly as she pleases ; and in the same pro- 
portion that she pulls on these handles she increases the 
support on the knees. 

We will now turn our attention to the very important 
agents more immediately and directly connected in this 
great work, i. e. ; the safest, easiest, and the most expedi- 
tious mode of delivering a female from the excruciating mis- 
eries of child-birth. This will bring us to treat of the ab- 
dominal muscles. They are the most efficient, powerful 
and direct agents of all the voluntary muscles that are call- 
ed into action in the great work of re-producing the spe- 
cies, and those more immediately concerned in respiration 
come into the next class. 

The abdominal muscles consist of three layers on each 
side of the abdomen, and one layer in front. 

1st. The Obliquus Descendens Externus — Arises 
by eight heads from the lower edges of as many of the 
inferior ribs, at a little distance from their cartilages. It al- 
ways intermixes in a serrated manner with portions of the 
serratus major anticus, and frequently coheres to the pecto- 
ralis major, intercostalis and latisimus dorsi, which last cov- 
ers the edge of a portion of it extending from the last rib to 
the spine of the ilium. It interdigitates by its five upper 
heads with the serratus major anticus,. and by the three low- 
er with the latisimus dorsi, where the latter arises from the 
rjbs ; a slip from the pectoralis covers the upper head. 

From these origins the fibres run obliquely downwards 
and outwards, or forwards, and terminate in the anterior 
half of the spine of the ilium, and in a tendinous membrane 
whose fibres are continued in the same direction until they 
meet the fibres of the corresponding tendon of the other 
side, in aline that extends frcm the ensiform cartilage (o 
the symphysis pubis* 



STJPPORTEfc. 43 

This line, from its white appearance, is called linea alba, 
which is owing to the connection of the different tendons 
uniting with each other without the intervention of muscu- 
lar fibres or any vessels that circulate red blood. On each 
side of this line are situated two long narrow muscles that 
do away with the white line ; but exterior to these muscles 
the tendons are again united and form a white line on each 
side, which, from its half-moon shape, is called linea semi- 
lunar is. 

At the lower part, or near the os pubis, the fibres are ar- 
ranged in such a manner as to form two very firm strong 
bands, called columns, which seem to increase the power 
of the muscle ; they form the abdominal ring, and give pas- 
sage to some vessels, &c. 

The uppermost of these two columns passes obliquely 
downwards and is inserted into the os pubis of the oppo- 
site side, near the symphisis, decussating the fibres of the 
corresponding columns of the other side. The lower edge 
of the tendon of this muscle is attached to the anterior supe- 
rior spinous process of the os ilium, and is there blended 
more or less with the fascia that passes down the thigh. — 
From this process the edge of the tendon is extended, in 
such a manner as somewhat to resemble the cord of a bow, 
across the concavity formed by the os ilium and the os pu- 
bis, and is inserted into the pubis near its symphysis. As it 
passes from the spine of the ilium to the pubis, the edge of 
the tendon is folded inward so that the edge of the mem- 
branous tendon is doubled. 

That part of it which is turned inwards is called Gimber- 
nat's ligament ; it commences small, continues so for some 
part of the way, but becomes larger, or at least much broad- 
er, just before its termination. The broad extremity is in- 
serted into the small process of the os pubis, near the sym- 



44 OBSTETRICAL 

physis, and into a ridge which extends backwards from the 
process to the brim of the pelvis, so that the tendinous mem- 
brane at this part is doubled — the part which is turned be- 
ing about an inch broad at the place of its insertion into the 
pubis. The edge formed by a fold of this membrane is call- 
ed Pauparfs ligament, and is very firm and strong, owing to 
the membrane being thicker at this place. It is the edge 
of the Paupart's ligament which is inserted into the ridge 
of the pubis, or its crest. 

All these parts of this large and very strong muscle are 
covered with a sheath, composed of very strong and firm 
fascia, which holds them steadily in their places ; and also 
intermix their fibres with the fascia, which extends i'ts^Jf 
over a very large surface, increasing the contractile power 
of the various parts of this muscle to a very great extent. 

The manner in which the fascia lata and the fascia super- 
ficialis abdominis insinuate themselves among the different 
parts of these muscles, so as to bind them down, hold them 
together, and apparently stimulate their contractile power, 
secures a great and important action, as well as an addition- 
al contractile power. The external oblique muscles com- 
press the abdomen with a wonderful power. Although, 
from its description, it may be seen that it is a muscle of 
great strength, still the power which it exerts many times 
to expel the contents of the uterus is truly surprising. If 
the diaphragm is in a passive state, they force it upwards, 
by pressing the abdominal viscera against it, and thus they 
are important agents in producing expiration, and its modi- 
ifications of coughing, sneezing, etc. They bend the spin3 
forwa.ds, and, by so doing, they approach the thorax to- 
wards the pelvis. When one acts separately, it bends the 
trunk obliquely to one side, or to the side on which it is 
situated. 



SUPPORTER. 45 

2d. The Obliquus Ascendens Internus — Arises ftom 
the spine of the ilium, the whole length of that portion be- 
tween the posterior and superior spinous process, from the 
Os sacrum, and the three inferior lumber vertebrae, by a 
tendon, or what is moie usually called fascia lumborum, 
which serves in common for this muscle, for the serratus 
posticus, for the latissimus dorsi, and Paupart's ligament, at 
the middle of which it sends off the beginning of the eremas- 
ter muscle. Some important vessels pass under this thin 
edge. Inserted into the cartilago ensiformis, into the carti- 
lages of the seventh and those of the false ribs ; but the up- 
per part of this muscle is more thin than the other, and re- 
sembles somewhat an apon eurosis, or tendinous membrane : 
it does not grow much fleshy until near the tenth rib. Here 
its tendon evidently divides into two layers. The anterior 
layer, with a great part of the inferior portion of the poste- 
rior one, joins at this point the tendon of the external ob- 
lique muscle, and passes over the rectus and is inserted 
into the whole length of the linea alba. 

The remaining part of the posterior layer joins the ten- 
don of the transversalis muscle, about midway between the 
umbilicus and the os pubis ; below this very few of the fi- 
bers of the posterior layer are seen, for the remainder of it 
passes before the rectus muscle and is then inserted intq 
the linea alba ) so that the whole tendon of the external ob- 
lique muscle, with the anterior layer of the internal oblique 
muscle, passes before the rectus muscle } and the whole pos- 
terior layer of the internal oblique, together with the whole 
tendon of the transversalis muscle, except at the inferior 
part ; that passes behind the rectus, and is inserted into the 
linea alba. At its extreme inferior part it is ins?rted into 
the anterior part of the os pubis. Use, to assist the former, 
but it bends the trunk in an opposite direction. 



46 OBSTETRICAL 

3d. The Transversalis — Arises, tendinous, but soon 
becomes fleshy, from the inner or back part of the cartila- 
ges of the seven lower ribs : from this point some of its fi- 
bres mix with and are continued along with those cf the 
diaphragm and intercostal muscles, by a broad thin tendon : 
it is connected with the transverse process of the last ver- 
tebra of the back, and the four superior vertebrae of the 
loins, fleshy, from the whole spine of the os ilium, inter- 
nally, and from the tendon of the external oblique muscle, 
where it intermixes wiih some fibres from the internal ob- 
lique. Inserted into the cartilago ensiformis, and into the 
whole length of the linea alba, except its lowermost part, 
Use, to support and firmly compress the abdominal visce- 
ra ; and it is exceedingly well adapted to the latter purpose, 
so much so, that it might with much propriety be called 
the proper constrictor of the abdomen. 

The long central muscle, called Rectus Abdominis — 
Arises by two heads from the ligament of the cartilage 
which joins the two osa pubis to each other — runs upwards 
the whole length and parallel to the linea alba, growing 
broader and thinner as it ascends. Inserted into the carti? 
Jages of the three inferior true ribs, and frequently inter- 
mixed with some fibres from the pectoral muscle. 

This /nuscle is usually divided into three tendinous inter- 
sections — the fir,&t, at the umbilicus — the second, where it 
turns over the cartilage of the seventh rib — the third, about 
midway between these points ; and there is frequently & 
half intersection below the umbilicus. 

These intersections, or linae trans versae, seldom penetrate 
through the muscle — adhere quite firmly to the anterior 
part of the sheath, but very slightly to the posterior layer. 
Use, to compress the fore part, but particularly the lower 
part of the abdomen ; to bend the trunk forwards, and, 
>yhen the superior extremity is fixed, to raise the pelvis. 



SUPPORTER. 11 

The structure and divisions of this muscle show the won- 
derful adaptation w r ith which nature has fitted organs or 
parts to the functions which they are to perform. The differ- 
ent parts of this muscle will contract separately and inde- 
pendently of the others, and it is said to do it with equal 
power and efficacy as if the whole muscle was called into 
action at the same time ; and when any particular part of 
the muscle contracts, it acts directly upon that part of the 
abdomen with which it is connected ; and, of course, when 
they all contract together, all the parts connected with it 
are affected at the same time. 

But another advantage is gained by the structure of this 
muscle, aside from the fact that it will act upon a local 
puint and no other. When the whole of this muscle acts 
together, it only produces a slight undulation on the surface 
of the abdomen — whereas, if a muscle of that size and length 
should contract from one end to the other by a continuous 
set of fibres, it would produce so large a tumor that it would 
not only be inconvenient, but in that situation would very 
much disfigure a person. 

The short central muscle is called Fyeamidalis- — Ari- 
ses along with the rectus, runs upward, enclosed in the 
same sheath, and is inserted by an acute termioa'.ion mere 
than half-way between the os pubis and the umbilicus, into 
the linea alba and inner edge of the rectus muscle* Its Use 
is probably to assist the inferior part of the rectus. I say 
probably, because it is sometimes wanting, without any 
great inconvenience. 

This closes my description of the abdominal muscles, or 
those on the external parte of it. Of their use, power and 
benefit in parturition it is not easy to mistake ; but I shall 
say more of that hereafter, and probably in a more connect- 
ed form ; or, at least, I shall endeavor to put all of this ma- 



4Q OBSTETRICAL 

chine together, both the natural and the artificial, and show 
the manner in which they co-operate and the assistance 
that one renders to the other, in such a manner that the 
mind's eye can take them in at a glance. So vastly impor- 
tant are they to the parturient female, when a fair opportu- 
tunity for them to exert themselves exists, that they must 
not be passed over lightly. 

There is one other muscle, though usually considered to 
be almost entirely appropriated to respiration, and in fact is 
a very important agent and performs a very large share of 
that life-sustaining act which we call breathing, still so 
great is the assistance which it gives when acting in con. 
junction with the abdominal muscles in the act of parturi. 
tion, that it certainly deserves a few passing remarks by 
w r ay of description ; and so immediately commingled and 
intimately connected are the actions of all these muscles, 
that it seems fully to warrant a description of this. It is call- 
ed the Diaphragm. It is a Greek word, and literally trans- 
lated it means inter septum,. It is the transverse partition 
between the abdomen and the thorax. 

It is not merely a transverse partition betwixt these two 
cavities, but it is a vaulted division betwixt the thorax and 
abdomen ; and not only is the middle raised into a vaulted 
form, but its obliquity is such that though its forepart is as 
high as the sternum, its lower and back part comes from 
near the pelvis, from the lowest vertebrae of the lcins. It is 
a thin muscle, and very broad in the middle of it reaching 
as high on each side, in the thorax of the skeleton as the 
fourth rib. It is commonly divided into two portions. 

The superior or great muscle ol the diaphragm, which 
arises by distinct fleshy fibres from the cartilago ensiformis, 
from the cartilages of the seventh and all the superior rib* 
of both sides. The fibres from the ensiform cartilage, and 



SUPPORTER. 49 

from the seventh and eighth ribs, run obliquely upwards and 
outwards — from the ninth and tenth, transversely inwards 
and upw r ards, and iiom the eleventh and twelvth oblique* 
ly upwards. 

From these different origins tire fibres run like radii from 
a circumference to a centre. Inserted into a cordaform ten- 
don of considerable breadth, w r hich is situated in the mid- 
dle of the diaphragm, and in which therefore fibres from op- 
posite sides are interlaced. 

There is a perforation towards the right side which trans- 
mits the venacava inferior, and the mediastinum and the pe- 
ricardium are connected to the upper convex part of it. 

The inferior or lesser muscle, or the appendix of the di- 
aphragm, arises from the second, third and fourth lumber 
vertebrae, by eight fleshy tongues, or heads, of which two 
in the middle are longest : they are called crura 9 and are 
usually tendinous. 

The aorta and thoracic duct pass between these, and 
the great sympathetic nerve and vena azygas pass on the 
outside and perforate the shorter heads. Those muscular 
fibres which run obliquely upwards and forwards from the 
two middle fleshy columns, decussate and leave an open space 
which transmits the cesaphagus and eighth pair of nerves, 
On either side of the lower portion of this muscle ar« 
formed two bow-shaped ligaments, inserted, by strong 
iieshy fibres, into the posterior portion of the middle tendon. 

The diaphragm is the principal agent in respiration, and 
more particularly that of inspiration, For where these dif- 
ferent fibres act to biing themselves into a plain, by their 
simultaneous action on the middle tendon, by which the 
cavity of the thorax is enlarged, particularly near the sides 
where the lungs are mostly situated, (it is a well-known 
fact that the lungs are always contiguous to the inside of 

E 



OBSTETRICAL 

the thorax and upper side of the diaphragm,) the air rustl- 
es into them to fill a vacuum or increased space. This mus~ 
cle is assisted by the two rows of intercostals which elevate 
the ribs and the cavity of the thorax is still more enlar- 
ged. 

During violent exercise, or whatever other cause drives 
the blood to the lungs with increased celerity, the pectoral 
muscles, the sarati, antici majoris, sarati posteri superioris 
and scaleni muscles affect the lateral dilatation of the tho- 
rax, when brought into action ; and the muscles which arise 
from the upper part of the thorax also assist by fixing the 
scapula, and then move the ribs on the scapula in laborious 
breathing. The diaphragm is pushed up, in rather a relax- 
ed state, during expiration, by the action of the abdominal 
muscles contracting on the viscera of the abdomen, and they 
press it upwards at the same time that their combined ac- 
tion with the sterno cos'alis, ssrrati, and postici inferioris 
pull down the ribs, and by the elasticity of the cartilages 
that join the ribs to the sternum they derive a powerful 
assistance ; hence it can readily be seen how the cavity 
of the thorax is diminished and the air expelled from the 
lungs with much ease. The diaphragm is however the 
principal agent in the dilatation of the chest in the act of 
inspiration. The quadrati lumborum, the sacro lumtalis, 
and the longissimus dorsi, all assist laborious expiration 
from dispnea, in asthmatic affections, etc., when the scapula 
is fixed, by pulling down the ribs. The diaphragm is arch- 
ed when relaxed, the top of which is very nearly on a level 
with the anterior portion of the fourth rib. This arch is 
flattened when the dipahragm is contracted, though the cor- 
diform tendon is siid to be very little depressed, and of 
course in proportion as the abdominal viscera are pressed 
downward, the cavity of the thorax will be increased : this 



SUPPORTER. 51 

downward pressure of the viscera causes that swelling or 
protrusion of the abdomen which we observe during inspi- 
ration. 

The diaphragm and the abdominal muscles usually an- 
tagonise each other, from the fact that they contract alter- 
nately. Occasionally, however, they contract in perfect 
unison, and this is the fact when they are called upon to 
act in that great and important work for which we have 
brought them into notice at this time — that is, to assist the 
womb in the expulsion of the foetus, at that momentous 
period when a fellow- being is about being brought into ex- 
istence ; or rather to be made conscious of its existence. — 
When they do act in unison, they compress the viscera and 
their contents between the two plains which they form 
with each other, with such a tremendous force as some- 
times to cause hernial protrusions. This is not the case, 
however, in labor, as the womb lays anterior to the other 
viscera, and consequently occupies the region where her- 
nial protrusions take place. This fact obviates the dan- 
ger at such times. 

Finally, the diaphragm is a noble muscle, and might "well 
call forth from Hallar that flattering cognomen, s< Noblissi- 
mus post cor musculus," We may smile at Buffon, who 
was a much better geologist than anatomist ; and after all, 
it is no £reat wonder that he should mistake its central ten- 
don for a nervous centre, the place from which originate all 
our emotions, and the seat of the soul. 

This closes what we have to say on the muscles by way 
of description, and we believe that the description embra- 
ces nearly all that are directly concerned in the process of 
parturition. We have mentioned, or briefly referred to, 
most of those lhat are indirectly called into action in the 
performance of this great work. It is nothing less than 



52 OBSTETRICAL. 

the fulfilment of that edict which has gone abroad on all the- 
face of the earth, from pole to pole, embracing latitudes and 
longitudes to their utmost extent, and it comes from no less 
a personage than Him who made heaven and earth and 
sea — who has said, " multiply and replenish the earth, and 
add to the numbsr of those who shall add to the glory of 
my creative power." 

As guardians of the common weal of mankind, it is not 
too mush to expect of us that we should emplo} 7 - our minds 
and inventive powers to soothe and alleviate the sufferings 
of that portion of our race on whom the great burthen of 
the fulfilment of that command seems to fall with an al- 
most crushing power ; and if we can accomplish anything 
in this way, let us not doit w 7 ith a grudging hand, but free- 
ly exert ourselves to the last extent of our abilities. Who, 
then, among the wise men w r ho have an oriental abode at 
this day, shall dive into the unfathomable depths of futuri- 
ty, and bring to our view the importance that may be at- 
tached tolhe safe delivery of one single case of child-birth. 
The w r or.h of the mother may, to some extent, be appre- 
ciated by us ; but the value of the one to whom she is 
about to give birth, either to its friends or to the world at 
large, can only be known to an Omniscient God Himself ! 
Who but Him can tell whether the unborn will n,ot be 
one who shall sway sceptres, kingdoms, kings and empires,, 
as the gamester moves his miniature great ones across the 
pfa:e of the chess-board? or whether, in science and phi- 
losophy, he shall not be a Franklin or a Newton, a.Gali- 
leo or a Harvey ; or in war a Washington, a Napoleon, a 
Caesar or an Alexander ? The fact that this, offspring may 
be equal to any of these, shows the great importance at- 
tached to the safe delivery of the same; and it also shows 
another important fact in connection w T ith the above, that 



SUPPORTER. 53 

it never should be entrusted in the hands of quacks and ig- 
norami, who stalk abroad on the earth like a destructive 
mildew that blights the hyacinth and the rose ere their ver- 
dure and their sweet perfumes gladden the senses of an ex- 
pectant world. And he who shall facilitate this work, and 
at the same time add to its safety, shall not only assist in 
the obedience of God's command, but be doing a service to 
his country of more importance and of greater value than 
all the gold contained in the vast regions of California, or 
all the diamonds that ever sparkled on the diadems of mon- 
archs. Then it is certainly worth our time, our exertions, 
our highest aims and most untiring efforts, mental and bo- 
dily, aided by all the inventive genius that we have power 
to cultivate or otherwise command, and concentrate them 
all on the one great object to project, and bring forth some 
instrument that shall render safe and easy this great work; 
and then most humbly and devoutly invoke the aid and the 
blessings of God that we may succeed in these our lauda- 
ble and praiseworthy objects. This is the work assigned, 
and, as far as we are concerned, with all confidence of suc- 
cess, to the Obstetrical Supporter. 

I have previously remarked that I had tw r o principal de- 
signs in the application of the Supporter to obstetrical pur- 
poses; and in presenting it to the consideration of my pro- 
fessional brethren for their approval or disapproval, as its 
benefits or inutility may strike their judgments, I might 
add a third, which, perhaps, had ought to have been the 
first one named- — that is, the increased safety which it af- 
fords to the parturient patient in those critical, and, in most 
cases, dreadful moments of her life. In those terror-fraught 
moments, big with important events which are about to 
transpire with the patient, she certainly requires all the 
aid and support that can by any means be afforded her to 

e2 



5 i OBSTETRICAL 

inspire and sustain all the fortitude, hop3 and courage' 
which lies in the power of temporal things to impart to 
her ; and let us never tire or £ar of doing too much in the 
right way to enable the poor suffering female to pass thro' 
this soul-trying ordeal. These important results we also 
most confidently claim for the Supporter, and only ask, by 
way of confirmation, a fair trial by those who are blind in 
unbelief. 

As the description of th's Instrument has heretofore been 
but partial* and quite imperfect, I shall now proceed to a 
more minute account of it ; and however imperfect it may 
be, I hope to render myself intelligible to those most direct- 
ly interested in its operation. 

It has, 1st, a back pad, which is composed of a central 
metallic plate to give and maintain its form : this is cover- 
ed on one side with leather of some kind, such as strikes 
the fancy of the maker as being the best — on the other side 
it is nicely cushioned, so that it will press upon the back 
with all of its inner surface and with perfect ease, even 
when the pressure is very great. The pad is oi somewhat 
conical or cordiform shape, with the base of the cone up- 
wards : it is convex externally, and concave internally : it 
fits very nicely to the back, which holds it firmly and with 
ease, and may be put on or moved so as to apply the pres- 
sure directly over the seat of the pain, or the part that re- 
quires to be held. The manner in which this pad fits the 
back, and the amount of pressure which this instrment en- 
ables the patient to apply to it, holds the back most deci- 
dedly better than any other mode that I have ever seen tri- 
ed j nor can I now conceive of a better plan to accomplish 
the important object allotted to this division of the Support- 
er. I never could conceive why this method should be ob- 
jected to by any person who had the least idea that that 



SUPPORTER. 55 

support was ever required for the back in any case ; and 
certainly it is a general rule, and it is well known to all who 
have any knowledge on the subject, that females require 
the back to be supported, and usually they require the sup- 
port to be very strongly applied during child-birth, The 
exceptions to this statement are barely sufficient to make it 
a general rule. Then, since this support is almost univer- 
sally required, it seems to me to be the height of folly to re- 
ject the very best mode that has ever been devised to make 
and apply that support. And it is equally w r ell known to all 
that this support, or counter-pressure upon the back, when 
judiciously and properly applied, mitigates the pain and the 
suffering consequent therefrom to a very great extent, and 
many times relieves it entirely. Then I repeat, that no 
philanthropist will reject or oppose the best means to re- 
lieve the sufferings of our fellow-beings ; and particularly 
to that portion of them to whom our best gratitude is due. 
2d. The main strap, which may be made of leather or 
other material of sufficient strength to hold the. amount of 
pressure that is necessary to apply to it. The force- appli- 
ed to these straps varies very much, and this variation de- 
pends upon the expulsive efforts of the voluntary system 
and the contractile power of the muscles which are enga- 
ged. In healthy and muscular females, this power is very 
great, and sometimes almost supernatural. This strap pas- 
ses through two loops on the back pad, then comes for- 
ward and passes over the hips, then along the thigh and 
around the knees. It holds and supports the hips as it pas- 
ses over them. In some cases, and in particular stages of 
labor, the pain in the hips is quite severe, and sometimes 
excruciatingly so : in these cases, this strap affords a very 
great relief. Aftjr passing round the knees, the ends of 
this strap are made to approximate the back pad to a dis- 



66 OBSTETRICAL 

tance of a little more than half-way up the thigh, where 
they are fastened to the strap as it passes down the thigh. — 
This must be done in a workmanlike manner, so that the 
strap will set perfectly smooth on the thigh. This forms 
two loops, into which the knees may be planted and held 
with great firmness and stability, which gives a sensation of 
support and increased strength that is felt through the whole 
muscular system. This seemingly increased strength in- 
spires hope and confidence : this mental buoyancy does 
away fear, despondency and all the other depressing pas- 
sions, and the labor proceeds with regularity and dispatch ; 
which is exceedingly agreeable to both patient and friends. 

On this main strap and near the back pad on either side 
are two strong leather straps with buckles fitted to each, so 
that the length of the strap may be readily adjusted to the 
length of the thigh of any person. 

3d. To those loops which hold the knees are attached 
two sliding pads, held by two narrow loops that slide on 
the loops of the main straps, so that these pads maybe mo- 
ved as the length of the main strap is altered, so as always 
to bring the pads directly over the knees. The use of these 
pads is to prevent the pressure of the straps from becoming 
painful to the knees in protracted labor, and the benefits 
which they afford are not to be neglected, for the trouble 
of moving them is nothing, nor does it take up a moment's 
time. 

4th. There is a narrow strap that is made fast to one side 
of the loop that passes over the knee : this narrow strap 
then passes directly under the foot of the patient, and to 
its other extremity is attached a buckle which buckles on 
to a short strap of the same width, which is attached to the 
loop that passes over the knee on the oppnsite side from 
the attachment of the long strap. The use of this strap is to 



SUPPORTER. 57 

prevent the possibility of the main strap slipping oft" from 
the knee when the patient pulls hard by the handles, or in 
case she should pull on the handles before the extension is 
made of the thighs on the pelvis ; and wh^n the patient 
lays on the side it gives additional support to the whole 
lower extremities. But when the patient is in a sitting po- 
sition, or lies on her back, the feet rest upon some other 
substance, and do not require that support. The extension 
should be made by the knees in the loops of the main strap 
in all cases. 

5th. There are two handles — they are constructed 'as 
follows : there is a strap to each knee, which passes thro 7 
the loops of the movable knee-pads — the ends of these straps 
come up on each side of the thigh, and are then attached to 
each end of a handle that lies transversely across the thigh, 
approximating near enough to the pelvis to make it conve- 
nient for the patient to grasp them with her hands. The 
shape of these handles is so well adapted to the grasp of 
the hands that no cramping or any other difficulty whatev- 
er attends this action : they are covered w T ith soft velvet, so 
that they can cause no uneasiness to the hand when the pa- 
tient pulls hard upon them, and the patient may pull on 
them as hard or as lightly as she chooses, and in prcportion 
as she pulls on the handles, the pressure and support of ths 
knees will be augmented. 

It will be found in practice that the patient always wants 
to grasp something with the hands, and either pull 
or push on whatever they lay hold of: the reason of this 
will be explained hereafter, in connection with a condens- 
ed description of the natural and artificial parts together. 
1 think it better for the patient to pull than to push, from 
the fact that both the abdominal muscles and the diaphragm 
act with greater force and efficiency when they pull : still, 



58 OBSTETRICAL 

they will many times grasp the main straps as they pass 
down the thigh, and push to very good advantage : but I 
have almost universally found, where the patient was in- 
clined to push, that, with a little timely and well-directed 
advice, they can be persuaded to pull on the handles ; and 
after they have made the experiment two or three times 
they will do it with all the ardor and zeal of those who 
commence it with their own freewill and accord. I have 
never yet had a case that, with a little tact and manage- 
ment, did no!; terminate in this way. 

I have now given descriptions of those parts concerned 
in parturition, which were formed by the God of Nature 

for that end some of these havebeen quite brief, others 

more at length and detail. I have also given you a descrip- 
tion of that Instrument which we have intended, and which 
we design to be a co-worker with the former — extending an 
auxiliary hand to those natural parts to assist them to bring 
to a speedy, safe, and, in every other way, successful termi- 
nation, the painful labor in this department of the great 
work of re-production. 

I will now proceed to give in a more connected form the 
manner in which I propose to accomplish the two great de- 
signs which we had in view in the invention and introduc- 
tion of this Instrument, viz., to facilitate the process of la- 
bor, and at the same time to mitigate the sufferings and the 
agonizing pains of that portion of God's creation on whom 
the curse of the fall seemed to light with a heavy and a 
withering hand. 

The process of parturition is of a very complex nature, 
from the fact that there are a very great number of parts- 
involved in the operation, and these of a very heterogeneous 
nature ; and great care and some little skill is required to 
give the separate functions of them all in a clear and com- 



StOTORTEft. b& 

prehensive manner. But, poor a mariner as I am, I must 
launch away upon this stormy ocean with the best chart 
and compass which I have at hand, and put my hand to the 
oar and show my good will if not my success in this great 
attempt. 

With regard to the individual members that are connect- 
ed in this work I have given most of them in detail ; thai 
is, the great number of the voluntary muscles, their names, 
their insertion, and also their use, in the ordinary operations 
for which nature designed them to act; and, yery imper- 
fectly, the part w^hich they perform in the great drama 
which has caused them to appear before my readers at this 
time. The other cause of complexity arises from the differ- 
ence in the nature of those servants or agents who are call- 
ed upon to labor in this all-important field of operations. 

Those of the first class which we have mentioned we 
have already said were voluntary ; that is, they are under 
the power and control of the will or volition. The idll, as 
it were, issues its imperative commands to those voluntary 
agents, and the mandate is implicitly obeyed, if in the pow- 
er of the agent so to do. It is the exercise of the will over 
the abdominal and other muscles that constitutes the volun- 
tary part of labor, and it is to this part that we are able to 
render the most immediate and efficient assistance by art ; 
and here it is that the Supporter steps in, not as an intru- 
der, but as an important co-worker and an invaluable assis- 
tant in the labor that is before them. 

The other part of this work is done in a different manner 
and by another set of hands altogether: the operation is 
different — different causes are in operation to produce the 
same result, and these causes obey a different set of laws en- 
tirely. The actions which take place in this department, 
are called, in common parlance, organic, or involuntary : 



00 OBSTETRICAL 

they commence independently of any effoit of the patient, 
and proceed in the same manner. These actions are like 
an ancient description of the wind — we hear the sound 
thereof, but know not whence they come nor whither they 
go : they are not under the control of the will, nor do they 
obey its laws or its mandates ; but, like the Yankee soldier, 
they fight on their own hook. The organ of which I am 
speaking at this time, is called uterus matrix, or womb. — 
This is undoubtedly a muscle, as all its structure and func- 
tions show, and one of exceedingly great power, (as sad 
experience has sometimes taught me to my cost) ; but 
this organ, as I have before observed, is not, like those 
which I have described, under the power of the will. It 
acts entirely independent of all the exercises of volition : it 
is controlled by, excited to, and continued in action, by 
a cause or causes the nature of which it would be worse 
than useless for me to attempt to explain. 

Why it is that the uterus, after the lapse of a certain time 
from impregnation, should commence the process of partu- 
lition by a continued series of efforts to throw off its burthen 
or relieve itself of its contents, is more than I can tell ; and 
I shall spare myself the committal of one folly by declining 
to make the attempt. Long and many, tortuous and per- 
plexing, fine-spun but slack-twisted, are the theories and 
explanations that have been attempted to account for this 
wonderful performance of the uterus. Many a great man 
with a little mind has written lengthy and rlowery disser- 
tations on this subject, and embellished them with a kind 
of tea-bell eloquence that is more tongue than brains ; but 
they have probably been edified to a much greater extent, 
and far more agreeably entertained by their own research 
and eloquence than has fallen to the lot of any of their 
readers. 



SUPPORTER. 

This class of productions, as far as I have had the mis- 
fortune to examine them, have usually been the wild-fire 
productions or vagaries of some hair-brained fanatic, or pu- 
erile monomaniac. It is one of those unfortunate cases 
where philosophy has yielded the ground entirely, or con^ 
sented to amalgamate herself with a train of ill-conceived 
chimeras, and badly chosen hypotheses ; and the effect 
has been a darkening of the atmosphere of true science 
all around us, as with a fog of pestilential exhalation of poi- 
sonous effluvia and baleful ch oak-damps, thrown off from 
the quagmires and stagnant pools of fancy, without reason 
and imagination — without judgment. These writers, or 
will-o'-the-wisps, as they might be called, are those that 
we read of when it was said by the patunt one of old, u Yo 
darken counsel by multiplying words without knowledge.'' 

All that I shall attempt to say with regard to the efficient 
and final cause of the contractions of the womb al the end 
of a particular period of gestation to expel the foetus, is, that 
it is some inherent, instinctive, organic principle that God 
has implanted there, and it is subservient to certain calls of 
nature which she makes upon it whenever she stands in need 
of its assistance. 

We ail know the fact that after fecundation has taken 
plac6 3 and the ovum through the medium of the fallopian 
tubes has passed from the ovarium to the uterus, and about 
forty weeks or two hundred and twenty-eight days hare 
passed by, that the uterus then commences a most vigorous 
effort to expel its contents, which had laid there with per- 
fect quietude, and the uterus had carried it without a show 
of resistance for the space of ten lunar months. These ef- 
forts of the uterus to relieve itself of its contents, consist of 
a series of contractions and relaxations , which occur at 
greater or less intervals, attended with considerable pain 



{ Yi OBSTETRICAL 

and restlessness, usually accompanied with a desire \o 
move often from place to place ; and not very unfrequent- 
3y it is accompanied with a feeling of fretfulness and imp-a- 
lienee. This may occur however with any disposition, no 
matter what the natural affability or good- nature of the 
person may be : it is merely the effect of these contractile 
efforts of the uterus produced on the whole nervous sys- 
system, and takes place on the principle that effects follow 
causes. These symptoms, in connection with others not 
necessary to mention here, we take as the commencement 
of labor ; and these alternate contractions of the uterus are 
usually called by the patient and the attendants, ''grinding 
pains," from the fact that they give a kind of a grinding; and 
disagreeable sensation, without any particular expulsive 
efforts; and at this stage of the labor very little can be 
done by the way of art. This action being organic, and 
without the scope of volition — the organ to which these ef- 
forts belong, must do the work. 

The Supporter can do little or nothing at this time, ex- 
cept in those cases where there is great pain in the back 
from the commencement of labor; in these cases much re- 
lief may be afforded to the back. I have used it under 
those circumstances with most decided relief ; but when 
used at this time it should always be explained to the pa- 
tient that the relief to the back is all that she is to expect 
of the Supporter at this stage of labor. With this under- 
standing I have used it with the most perfect satisfaction to 
the patient, and to those who witnessed the effects; and I 
have thought sometimes that the expulsive efforts came on 
sooner and that the labor was terminated in less time than 
it otherwise would have been. But if the Supporter was 
injudiciously applied at this stage of the labor, with an en- 
couragement that it was going to enable her to be delivered 



SUPPORTER. 63 

at once, an inevitable and most injurious disappointment 
must be the result ; for it is not in the nature of things, 
without the direct interference of miraculous results, for the 
woman to be delivered before th«e mouth of the womb is di- 
lated. Consequently it would be most reprehensible in 
any person to hold out such hope to the patient, no matter 
what the power of the assistant was, if it was anything 
short of an omnipotent hand, I make these remarks from 
tlie fact that wicked and designing men might make use of 
this method to bring the Supporter into disrepute among fe- 
males, who, of course, cannot be supposed competent to 
judge of the philosophical operation of the instrument when 
-separated from that of her own experience. 

These dilating pains are not under the control of the will, 
they are made by the uterus alone ; and in making them 
the uterus obeys certain inherent and determinate laws, 
which I have already declined an attempt to explain. This 
part of the labor that is performed by the uterus is not on- 
ly different from the other or voluntary part of it, but it is 
also somewhat complex in itself. 

The uterus is a muscular structure of a peculiar kind, and 
is composed of two sets of fibres, with a power of contrac- 
ling on themselves; and this power is complicated in such 
a manner that these fibres act antagonistically, or in con- 
trary directions. One of these set of fibres are called cir- 
cular or transverse fibres, and when they contract they les- 
sen the transverse diameter of the uterus by approximating 
the parietes in that direction ; and it is these fibres, and par- 
ticularly those situated about the servix and 03 uteri, that 
enables the uterus to carry and sustain the weight of the foe- 
tiis during the time of gestation ; and when the fibres act 
in conjunction with the others, they oppose the dilatation 
ot the os uteri, and the expulsion of the head of the child 



S4 OBSTETRICAL 

through the mouth of the womb, just in pioportion to their 
contractile power. And even after the exit of the child's 
head through the mouth of the womb, a strong contraction 
of these fibres would firmly embrace whatever portion o^ 
the child remained within their reach, and consequently 
they would retard the expulsion of the foetus in the same 
ratio that these fibres are called into action. Hence g reat 
care should be taken that nothing be done to excite an un- 
due action in these fibres, otherwise the labor will be pro- 
longed, and the sufferings of the female will be augmented 
by such useless and injudicious management. 

It was for this reason that I declined the attachment or 
use of a fiont pad, (which I once had in contemplation,) to 
be applied to our Supporters, believing from the facts which 
I have here mentioned that its effects and operations would 
be to retard the work rather than help it, and that it would 
most certainly, inmost cases, prove a hindrance rather than 
a help. 

All the parts of our instrument, as it is constructed and 
used at the present time, are indicated by nature, and in- 
stinctively called for by the parturient female ; and I added 
ihem one by one in the various trials which I made, by 
watching the effects of those which I had, and the indica- 
tions or calls for those which I had not. But I never in 
all my practice heard a female call for pressure over the 
womb, or any part of the abdomen, during the time of child 
birth. And from the fact that this never seemed to be indi- 
cated by nature or called for by the patient, (if it was 
wanted it would be called for the same as other things they 
demand,) I have, as I believe very judiciously, and as a 
matter of safety, rejected it as worse than useless. 

In instruments, as in medicine, I consider that the indi- 
cations of nature ought in all cases to be the rule by which 



SUPPORTER. 65 

the bounds of safety are marked out; and they should 
also be considered the true landmarks by which all the con- 
struction and use of both instruments and medicines should 
be regulated. What are the great and primary objects of 
medicines and instruments as they are used to aid us in the 
healing art? It is not to create new principles by which 
we may lord it over nature, and compel her to bend herself 
in conformity to this or that arbitrary rule ; that would 
certainly lookjike being wise above what is written. Now 
to me it would look rather more becoming a poor short- 
sighted mortal to endeavor to assist nature to perform her 
own work in her own way ; and when she calls for aid, it 
becomes us, in all humility as her servants, to tender such 
things as we, after a careful examination and close and well 
directed obervation 5 find best adapted to satisfy those calls. 
And what she does not call for, let no one presume to force 
upon her in order to drive her from the path which God has 
marked out for her ; or what is still worse, make forced 
and gratuitous applications for the sake of filching from 
another what jusily and of right belongs to him. 

If any thing can ever be done by pressure on the ab- 
domen of the female during her accouchment, or if any thing- 
is ever required to be done in this way, it can be much 
better done by the hand of the accoucheur than by any 
other means under heavens; for by using the hand, 
the pressure may be made directly upon the fundus of the 
uterus, which might assist the longitudinal fibres to approx- 
imate the fundus towards the mouth, and thereby assist 
them in making the expulsive efforts to accomplish the 
delivery of the child. But nothing can be more clear to 
a mind of sufficient capacity to comprehend the mechanism 
of labor, than the simple fact that pressure made by a 
pad over the region of the lower circular fibres would stim- 

f2 



OBSTETRICAL 

uliite them to contract ; and just in proportion to that con* 
traclibility, as I have before shown conclusively, they will 
retard the delivery of (he child. I shall say no more on 
this branch of the subject, and to those who are not total 
and entire strangers to all the functions and operations of 
the different parts concerned in labor, I have already said 
more than was necessary. A wise man will be convinced 
with less than what has been said, and a fool will not be 
convinced though I had said a thousand times mere. And 
even if they were, it is a thriftless work to make such 
proselytes ; it is a kind of game that never pays for your 
powder and shot. 

The ether set cf fibres which enter into and belong to 
the structure and formation of the uterus, run in nearly an 
opposite direction from those that have been described, and 
consequently encircle the long diameter of the uterus ; 
and from this fact they are called longitudinal fibres. — 
When these fibres contract they approximate the fundus 
or top of the womb towards its mouth, which lessens the 
long diameter of the womb, and, at the same time, 
it increases the transverse diameter. The circular fibres 
resist this efeo.t of the longitudinal ones ; but, by a eontin- 
ed action of the superior power of the longitudinal ones, 
this resistence is overcome, and the os uteri becomes dila- 
ted — ready to give egress to the child's head as it commen- 
ces its first jour ne} T of life, I have spoken of the superior 
power of the longiiudinal fibres. I am aware that this is a 
controverted point, as regards the power of the two sets of 
uterine fibres ; but, from the simple fact that these two sets 
of fibres oppose each other at the commencement of labor, 
and that, in the end, the longitudinal ones prevail, it is ve- 
ry natural for us to conclude that thcs3 whose works pre- 
ponderate are the most powerful. 



SUPPORTER, 67 

Thus far the lator has progressed almost entirely by an 
involuntary action, or a series of them , which will have 
occupied a greater or less amount of time, just in proportion 
as the longitudinal fibres have been strong and active, or as 
the circular fibres have resisted their efforts. This is a 
very tedious part of the labor, and it is rendered much more 
so from the fact that these dilating pains are generally con- 
sidered by the patient and the attendants as being entirely 
useless ; because they do not u bear down," as they ex- 
press it, they think they are having all that suffering 
without any beneficial effects to repay them, and hence it' is 
that w r e so often see an impatience and fretfulness manifes- 
ted by the patient. The idea of suffering without any 
compensatory bliss to follow r , produces a depression of 
spirits and a despondency of mind, and this causes great 
irritability and excitability of the nervous system ; and 
from this state of the nervous system follmvs impatience 
and fretfulness, to a greater or less degree, with as much 
certainty as the needle follows the pole in the chambers ol 
the north. With this impression on the mind, the patient, 
and not unfreqaently the attendants, will importune the 
physician to give something to relieve them ; or in other 
words to produce better pains. But in this stage of the 
neither Supporter nor medicine can be made available, 
if the dilatation is proceeding properly. 

t is however a mistaken idea that these dilating pains 
are useless or unnecessary ; and this error should be cor- 
rected by the best means that may, under all the circum- 
stances, be suggested to the mind of the accoucheur. The 
fact is ; that these dilating or grinding pains are a prepara- 
tory process, and must, in ihe nature of things and of laws 
out of our control precede the real effective and efficient 
causes to produce the Lirth of a human being; and they 



68 OBSTETRICAL 

are as important as any other stage orpoition of the labor. 

When the longitudinal fibres have prevailed ov r er the 
resistance of the circular ones, and the mouth of the 
womb has become properly dilated, then a change comes 
over the face of things ; the labor is no longer conducted 
by the involuntary efforts of the uterus alone, but the vol- 
untary powers now offer their aid and assistance, and the 
pains seem to pass rather imperceptably from what the pa- 
tient and the assistants call grinding or useless pains to 
those which are accompanied with forcible bearing down 
efforts, which give the patient an impression that they are 
doing some good and are destined soon to relieve her from 
her sufferings. 

At this time she begins to have a strong desire to help 
herself, and, as the result of these desires, she wishes to 
make bearing down efforts simultaneously with the invol- 
untary contractions of the womb ; and now all the various 
parts and machinery of labor are brought into requisition, 
and so strong are the desires of the patient for what she 
thinks she wants, that it seems exceedingly hard that she 
should be denied . The mcst of these desires are instinctive- 
ly suggested to the female ; she cannot tell you why it is 
that she wants them, but she can tell you with a great deal 
of emphasis of the fact that she does want them. 

And now let us see what these calls of nature are which 
are suggested and required by the suffering female in this 
her hour of peril and tribulation. Usually the first thing 
called for by the parturient female after the efforts of the 
expulsive pains have fairly commenced, is to have her 
knees held firmly, so as to allow her to press on the point of 
resistance by extending the thighs on the pelvis ; at leas! 
the tendency of the effort is made in that direction and ii 
that manner. It is very seldom, however, that by tl 



SUPPORTER. 69 

means heretofore used the knees could be held with suffi- 
cient firmness to satisfy the wishes of the female, and it is 
more effectually done with the Obstetrical Supporter than 
it could be done by a combination of every other means 
that I have ever known. 

Next is a desire to grasp something with their hands and 
pull upon it with more or less force ; and the fact that they 
cannot give a philosophical or sciantific reason for these 
desires does not in the least degree diminish the desires 
themselves, nor does it satisfy the patient when she cannot 
be gratified. 

Next in order is the pain in the back ; this is not always 
very severe, sometimes it is slight and does not cause a 
great uneasiness to the patient. At other times it is most 
excruciatingly severe, so much so that it requires all the 
powers of endurance that human nature is gifted with, in 
order to bear it with any degree of composure. With all 
those powers of endurance for which females are so much 
celebrated, these sufferings will many times extort from the 
sufferers such cries and groans as will pierce to the heart 
even of the most careless spectator, and they are certainly 
any thing but pleasant to the ear of the humane physician, 
particularly when he is appealed to in the most earnest and 
supplicating manner to do something that will give them 
a few moment's relief from their anguish. How often 
would I have given any thing, or all things that I could 
have commanded of this world's goods to have been able to 
comply with and satisfy those pitiful appeals. But never 
did I realise the gratification of these laudable desires un- 
til I had the pleasure of using the Obstetrical Supporter ; 
and up to this time I never saw those pains mitigated or at 
all relieved, save in a very slight degree, and that in a very 
bungling and troublesome manner. How often have I 



70 OBSTETRICAL 

turned away in disgust from these unavailing efforts with 
the mental exclamation of ' c Oh ! my God ! are these suffer- 
ings never to be palliated by human skill ?" and a negative 
answer made our boasted science appear smaller than 
Hahnemann's 30th dilution of common coffee. 

But the long looked for and mach desired agent has 
come at last, with healing in his wings. I do not hesitate 
to say, and I say it without fear of contradiction by those 
who have made the experiment, that nineteen twentieths 
of all this pain in the back may be done away with by a 
judicious use of the Supporter. And if this was all that 
it effected, and its entire benefits were summed up in this 
one thing, it would well deserve and probably receive the 
patronage of the profession. 

I have now given a brief description of the organs and 
parts most directly concerned in the mechanism of labor, 
comprehending both the voluntary and the involuntary 
systems, and the manner in which each fulfil their sepa- 
rate appointments. I have set forth, according to the best 
of my ability, w r hat are the calls of nature in this great 
work, and how they are instinctively made known to the fe- 
male,who is the principal laborer to perform this great work; 
&nd also what are the materials which nature has put into 
the hand of the female to enable her to perform this work; 
and the manner in which the various parts of this machin- 
ery act when in performance of the task assigned to it.— 
Now, the question arises, can nature be aided in the per- 
formance of this work by the hand of art ? I answer that 
it can : others may say that it cannot. 

It d has already been said by some, (who are probably 
more conscientious than wise,) that any attempt to relieve 
the sufferings of the female in her agonizing struggles to 
give birth to her offspring, i$ striving against the edict of 



Supporter. 



i 



Jehovah. They say-that the pains incident to childbirth 
are the effects of the curse that was pronounced on woman 
in the garden of Eden for her disobedience in picking and 
eating and giving to the man that he might eat, the inter- 
dicted fruit, whereof it was said " thou shalt not eat," etc. 
Allowing this to be the case, for which, taking together all 
that was said at that time, there is some little plausibility; 
still it does not say that this penalty should remain eter- 
nally in force without any mitigation or palliation. If we 
take what was said against the woman by way of penalty 
inflicted on her in certain situations as the fruits of her 
disobedience, we will also receive what was said in her 
favor in connection with the former, eminating from tha 
same high power. After the pronunciation of the curse a 
word of comfort was spoken to th^ poor dejected female, by 
him on whose words are based the pillars of heaven and 
earth. He gave her to understand that though for a time 
she must be afflicted, nevertheless that the old wiley ser- 
pent, the devil, should not always hold dominion over her 
nor her posterity. But on the contrary it was said that the 
seed of the woman was to bruise this serpent's head ; by 
which she was undoubtedly to understand that the unlim- 
ited sway of the devil should be broken — that his domin- 
ion on earth should be scattered like chaff before the winds 
of heaven — and that with the cessation of this dominion 
should end his power to inflict pain and misery on the sons 
of men. Hence it is that the immortal Milton has not sung 
his paradise regained without good authority for so doing. 
And if the pain of childbirth is the penalty of the first 
transgression, judging from what little I have seen of those 
sufferings, it would seem to be placed beyond a doubt that 
the sin in question was most amply atoned for, so far as 
suffering could do it ; and that it is high time something 



7£ OBSTETRICAL 

was done to round off the sharp angles of these almost life 
destroying agonies, if it is in the power of man to accom- 
plish so great a work. And as respects the sin and iniqui- 
ty that rests upon oar endeavors to ameliorate these suffer- 
ings, I can only say that when I come to close up my career 
here on earth, and am called to render up to the bar of 
God an account, I do most devoutly pray that, no other sin 
may be found resting on my soul or standing between me 
and the celestial paradise, than my endeavors to render more 
safe and easy the entrance of posterity into this wicked 
world. 

Others have objected to our endeavors to give aid and 
comfort in this matter, because, say they, you have no right 
to do so ; and as evidence of this allegation they adduce 
the fact that labor is a natural process, and say that it is 
mere presumption to attempt an interference by the puny 
arm of art. I really think that the force of this argument 
will not knock a man down. As well might we say that 
tiaveling was a natural process and that the use of the 
lower extremities are all the means we have any right to 
make use of to perform that work ; and that steam bcati 
and rail road cars and all other locomotive engines are 
mere innovations and trespassers upon rature, and ought to 
be annihilated at once. By the same rale of logic, all our 
ordinary manual labor must be performed without any ar- 
tificial aid ; we must forever lay by, (not as useless, but 
unusable,) the advantage of the lever, the screw,the pally 
the wheel and axle, and all other artificial and mechanical 
powers which in the wisdom of man he has made subser- 
vient to his use and comfort. The same objection would* 
apply with equal force and pertinancy to all the obstetrical 
instruments that have been invented from the days of A- 
ristotle down to the present time. Finally, it is a sufficient 



SUPPORTER. 73 

answer to all these childish objections, to say that nature 
is not always competent to do her own work in her own 
way. There are accidents, deficiencies, and malforma- 
tions, all of which it is the business of art to remedy, as far 
as in it lies. In these, either the de&th of the child or the 
mother or both must ensue, or artificial aid must be given 
to the unavailing efforts of nature to finish her task. Then 
if life may be saved by our efforts, when scientifically and 
judiciously applied, in some cases, it follows with equal 
certainty that nature may be assisted under other circum- 
stances ; and that much pain and suffering may be saved 
by a timely exercise of the same kind of skill and efforts. 

And now, on taking a retrospective view of these things. 
I can lay my hand on my heart and say, the only thing 
that I have to regret in all this matter, whether it be in the 
sinfulness and impiety, or the impropriety of our endeavors 
to afford this aid, is, that I did not sooner bestir myself in 
the work, to invent or devise some means by which we 
might sooth, soften down, and heal those dreadful wounds 
inflicted by the barbed dart of sin on poor suffering rru - 
inanity. I know it was said to the woman in the garden of 
Eden, "In sorrow dhalt thou bring forth," alluding to the 
offspring ; and never has there been a more literal truth 
spoken from the whole volume of inspiration, and never 
was there a sentence executed more fully to the letter. 

We all know that it was said to man that the earth should 
be cursed on his account, including that hallowed spot on 
which he stood when he came from the hand of his maker 
in his primeval purity. The sentence passed upon man 
was no less explicit than that passed upon woman ; and 
from that oracle whose word can roll the everlastino* hills 
from their resting places, and cause mountains to spring up 
in the mighty deep ? the edict came forth, and poor fallen 



74 OBsTEfRfC^t 

man was informed that thorns, briars and thistles should 
spring up in the land whither he goeth ; and that with such 
a luxurious growth should they shoot forth as to take the 
place of those spontaneous and edible fruits which the ve- 
getable kingdom had heretofore yielded them in great a- 
bundance ; and as a necessary consequence of all this, it 
was said that man should gain his bread by the sweat of 
his face. There can be no mistake about the meaning of 
this language. Well, has man laid down under this sen- 
tence, and said, it is the edict of Jehovah and I must per- 
form all this work with my hands or natural limbs, and 
never exert myself at all to ameliorate my condition under 
this state of things ; or has he employed all the powers of 
his soul, mind and strength to render bearable and easy the 
work which was at that time allotted him to do ? I let the 
ten thousand times ten thousand different kinds of machin- 
ery propelled by water, wind and steam, aided by all the 
advantages of the whole series of combinations of mechan- 
ical powers, from old Archimedes down to the wiley Yan- 
kee, calculated to save the labor and sweat of man, an- 
swer this question. And sorry am I to say, although I be- 
lieve the assertion to be perfectly just and founded in truth, 
that so perfectly selfish has been the heart of man, that he 
has allowed his whole mind to be occupied with the desire 
to better his own condition, and with this desire has bent 
the whole force of his efforts and Ins energies to accomplish 
that end. In the mean time he has allowed the poor wo- 
man to welter unaided in her agonizing pains to bring forth 
an offspring that should prevent this earth from becoming 
a solitary waste. Up to the time of the application of our 
Supporter, and its adaptation to aid parturient females, 
very little has been done to assist her ; and that little has 
been in an inefficient, incomplete, bungling, perfectly un- 



SUPPORTER. ?5 

scientific and unsatisfactory manner. . And I appeal to the 
sorrowful experience of every female who has gone through 
with this ordeal, the terror and torments of which are lit- 
tle less than the rack and the wheel of inquisitorial memo- 
ry, to verify the truth of the assertions I have made on this 
occasion. What has been the occasion of all this deficien- 
cy in the obstetrical art. It has not been for the want ot 
inventive genius; enough of that has been abroad in the 
world to supply this and every olher call that might be 
made upon it, and enough of it a thousand times over has 
been wasted on the desert air, which if turned into the pro- 
per channel might have devised some means for the relief 
of poor neglected females centuries ago. 

The solution of the cause, then, why this deficiency has 
been so general and so wide spread all over the earth, 
must have been a want of attention, an inexcusable care- 
lessness on that point of obstetrical practice. Aud why 
this carelessness ? Probably not from a want of respect 
to females, nor from an indifference or want of sympathy 
for their sufferings. I think there are two causes to which 
maybe referred these laches in our profession. One of 
these I have already adverted to, that is, the selfish occu- 
pation of our minds for our own special benefit ; the other, 
it is to be feared, has grown out of an error promulgated 
from high places, and from the mouths of those who ought 
to have spoken better things in the name of their profess- 
ion to those poor mortals who are obnoxious to the penal- 
ties of sin — pain, sufferings and death. None of these are 
charged as growing out of a wicked or perverse heart or a 
depraved mind ; nor is it believed or intended to be con- 
veyed by the writer, that these errors have grown out of 
any malevolent feelings harbored by those w r ho made these 
erroneous statements. They seem rather to have grown 



• O OBSTETRICAL 

out of an unfortunate amalgamation of the first and second 
stages of labor, and from the very obvious fact that no effi- 
cient artificial aid could be given to the former, that of ne- 
cessity it would follow that nothing could be done for the 
latter. 

We are all well aware that the edict has gone forth, that 
nothing can or ought to be done to aid or relieve a natural 
labor ; that there is a certain natural routine of operations 
to go through with, and it is only the reckless, the pre- 
sumptuous, and the igaorant, who will attempt to do any 
thing. 

This error has been copied from author to author, and 
handed down from the wise of one generation to the wiser 
of another, till finally this antedeluvian shade has become 
venerable from its great antiquity, if not from its philosoph- 
ical veracity ; and so long has this been kept before the stu- 
dent and the practitioner, that it is now received as a self 
evident fact that nothing can be done. Hence, if the 
mind has glanced upon the subject for a moment, it has not 
been allowed to dwell there long enough to reflect whether 
this assertion is founded in truth or error, but has been in- 
stantly thrown off from the subject by the very sage reflec- 
tion that great men have said that nothing can be done, 
ergo, nothing must be attempted, not even so much as to 
weigh the probabilities of the success or failure of a trial. 
It wculdseem that the idea of affording relief to a case of 
natural labor was clothed v/ith a most awful majesty, and 
arrayed in some fearful garb that struck instantaneous ter- 
ror to the s'outest heart ; and no sooner is the idea reveal- 
ed to the perception than the beholder is struck dumb with 
affright, then turns and flees as if a thousand demons were 
leagued in the pursuit.. 

Now I am not one of those who are fond of making u> 



SUPPORTER. 77 

discriminate and uncalled for innovations upcn old, long- 
established, and well tried principles and usages ; partic- 
ularly when the new idea strikes at theroct of the tree that 
was planted and nourished by my superiors. But it so hap- 
pens that I have lived long enough to learn that great men 
are only human, after all that may be said or sung of 
them, and that they are liable in common with their fellow 
mortals to commit an error. Unfortunately for them, and 
for us all, in this plain republican country, where each one 
thinks and acts for himself, none are infallible. 

In this generation of wisdom, wonders and intelligence, 
I presume the idea will not be controverted that a great, 
wise, learned and good man, in saying a great many things, 
may at some time in his life say something wiong ; and 
having come from a great man, it may be copied, circula- 
lated and acted upon, by men great and small, for a suc- 
cession of years or generations, and at last some blockhead 
like myself may detect the error. If so, I have an un- 
doubted right to correct it, and none has a right to resist 
me ; and the correction of the error may be as important 
and as beneficial to mankind as if it had been made by one 
of the great ones of the earth. A correction of this kind 
does not make me the greater man, nor the one who com- 
mitted the error the lesser one ; while the great man may de- 
tect and correct a thousand errors of mine, I have an equal 
right to correct one of his, if it comes under my cogni- 
zance, and within the scope of my perception. We are not 
to say, because a man is learned and wise, that his fallibil- 
ity is not to be questioned, or his known errors corrected. 
This would be striking at the foundation of truth and all 
good principles, by which we may distinguish right frcm 
wrong ; the destruction of which would level mankind al- 
most to the brute creation. 

g2 



/b OBSTETRICAL 

I have had the hardihood to attempt a correction of these 
errors by the introduction and recommendation of our Ob- 
stetrical Supporter, and have taken a position that it is a 
real and substantial benefit to those it was designed to 
help; and have assumed the responsibility to aver that it 
will give aid and comfort to parturient females in all na- 
tural labors. If on trial, however, it proves to be of no 
service, a mere dead weight on the practice of the obstet- 
rical art, of course it will fall into deserved neglect and 
disuse ; and the id 3a will remain in the ascendant, that 
nothing can be done. On the contrary, if it does all we 
claim for it, then the instrument will continue to be used, 
(and with greatful hearts by the females at least,) until 
child-bearing shall have gone out of fashion, and there is no 
more call or necessity for re-production of the species. If 
1 may be allowed to judge from the past, I think it safe to 
predict that the destination of this instrument is onward, 
onward , until its beneficial effects shall encircle the earth — 
until the rays of the bright luminary of heaven shall not 
shed his beams on a portion of our globe where its utility is 
not known and appreciated. And it will probably be found 
by those who make the experiment, that a sneer or a vain 
and shallow attempt at ridicule, by weak, barren and gro- 
velling minds, will never retard its progress. As well 
might these puerile efforts be put foith to suspend the di- 
urnal motion of this earth, and thereby shut the vivifying 
rays of heaven's sparkling fountain forever away from us ; 
or in the simplicity of their juvenile minds, make the ab- 
ortive attempt to extinguish the flames of Vesuvius with 
sulphuric ether. 

The honest fact is this, and it is the summing up of the 
whole matter as far as opposition is concerned, the instru- 
ment is of real and substantial benefit ; and those interest- 



SUPPORTER. 79 

ed in its operation will so find it, and they will not be de- 
nied the privilege of availing themselves of its benefits. 
Hence arise my confident assertions that no opposition that 
may be offered by trifling or fault-finding individuals will 
ever be effectual in retarding its onward course, to merit 
and receive a universal approbation. 

Why it is that an opposition should be offered or at- 
tempted against the Obstetrical Supporter, is more than I 
can tell, or have any conception of. It carries out the 
principles that we have been acting upon from time imme- 
morial, with this difference, that the means formerly used 
were inconvenient, inefficient and unsatisfactory to the pa- 
tient, and harassing and fatiguing to the attendants. The 
Supporter does all that has heretofore been attempted, and 
does it in a neat, safe, efficient and satisfactory manner to 
the patient ; and relieves the attendants entirely. If these 
are objectionable parts or properties loan instrument, then 
let us have them ; if they are not, then reserve the objec- 
tions for an occasion where they will be more useful. 

The soi desant, great man in her Majesty's dominions, 
one who is intrusted with the perservation ot the life and 
the continuance of the health of his fel'ow beings, to some 
extent ; who has also the high responsibility resting on his 
shoulders of moulding the principles, storing the minds, 
and otherwise equipping those young men with the proper 
armor who are holding themselves as candidates for that 
high, humane and honorable station of guardians of heahh 
— he should have been the last one to reject the benefits 
of the Supporter to those who look up to him for aid in 
time of trouble and distress ; and also to refuse to impart 
a knowledge of its benefits to those who are dependant 
upon him for that knowledge which is to regulate their 
future conduct and lav a foundation for their usefulness in 



80 OBSTETRICAL 

ail time to come. Such men should not be so puffed up 
with a fallacious idea of their own far seeing wisdom and 
clairvoyant foresight of futurity as to think themselves 
capable to predict with certainty the future destiny and 
ability of our instrument, without an ordinary examina- 
tion or a moment's reflection ; nor should he, when ad- 
dressed in a gentlemanly manner, put on such an air of 
pomposity and assume such a commanding position that it 
would be perfectly withering to a man in the common walks 
of life ; then under a garb of all this dignity and dignified 
ostentation undertake to cover up an unpardonable ignor- 
ance of the operation and utility of a thing, by coolly and 
sneeringly calling it a u yankee notion," closely allied to 
wooden nutmegs, etc ; and under the same transparent 
veil of would-te-greatness undertake to excuse himself 
from approbating the thing by saying that it was improper 
for ladies to exert themselves with such an instrument, and 
that he should have to take his servant with him to carry 
it around — (the " instrument weighs about 18oz.) — this 
aigumert weighs about as heavy as the instrument of 
which it complains ; and they are neither of thf m very 
alarming, except to weak minds. Nor do I believe that 
the public mind when rightly informed will allow h'm to 
reject an instrument of so much worth with impunity; and 
instead of taking the trouble of carrying the weight of one 
pound, or employing his servant to do so, he could indulge 
himself in the more pleasing employment, and claim it as 
a right due to his great dignity, to recline himself wi(h 
all ease and much complacency on a highly finished sofa, 
or other' convenient place for lounging, and allow the poor 
suffering female to waste her strength and prostrate all her 
vital energies with her unaided and almost unavailing efforts 
to relieve herself from the agonizing and terror-fraught 



SUPPORTER. SI 

sufferings incident upon childbirth. These things may pass 
on for a while until a knowledge of their afflicting and life 
destroying principles are made known to the community at 
large, then they will recoil with a deadly effect on the 
heads of those who have palmed them off on an unsuspect- 
ing and confiding people. Then these men who are wise 
above what is or ever ought to have been written will find 
that their assumed omniscience is the rock on which they 
split and made shipwreck of their terriffic prophesies, and 
that the stone which the builders have refused has become 
the chief of the corner, and on whomsoever it falls it 
shall grind him to powder. Now in taking leave of this 
subject, (on which I have probably digressed too far, for 
which I ought to ask pardon,) allow me to say to my 
friend, that in all human probability the popularity of this 
instrument will live and be cherished in the hearts and 
memories of those poor sufferers who have been aided by 
its beneficial and salutary influences, when all that shall 
remain of him will be his hie jacet on the cold marble, 
and his emphemeral fame shall be quietly reposing in the 
shades of oblivion. 

The question has been asked me, and probably will be 
again, that if it was necessary to call all those muscles 
which I have described into action to fix the points of at- 
tachment for the abdominal muscles, why they were not 
made fixed points from the beginning, and thus save all 
this trouble of using so many muscles, supporters and 
other apparatus to do the work that might have been done 
once for all. To these interogatories we may reply, that in 
nearly if not every other situation and condition in life in 
which these points of attachment or the bones to which 
they belong are employed for our benefit, it is most decided- 
ly necessary that they should be movable instead of fixed 



82 OBSTETRICAL 

bodies. I cannot now call to mind an other instance in 
which it is imperatively necessary that they should be 
firmly stationary in order to perform the function to which 
God had assigned them. It is indispensible that the move- 
ments of the trunk on the pelvis should be perfectly freo 
and unrestrained, in order to allow us to perform those 
well balanced movements by which we maintain the centre 
o£ gravity in an erect position, and all other positions 
which our various occupations render necessaiy for us to 
assume. Without this the sloth of South America would 
be a better locomotive than we should. It is of equal 
moment that the connection of the pelvis with the lower 
extremeties should allow a perfectly free and easy motion, 
in order for us to perform that almost constantly required 
act of locomotion, as well as to use the lower extremeties 
for a great number of other and nearly equally important 
functions, which could not be done were it otherwise. 

The motion of the ribs and sternum could not be dis- 
pensed with and sustain the life-preserving act of respira- 
tion ; or at least without these motions respiration would 
never fulfil the designs for which it was intended by our 
beneficient creator. The absolute necessity of the multi- 
form and unrestrained movements of the scapula, or 
shoulder blade, are too obvious to require a passing re- 
mark ; particularly when we take in connection the move- 
ment, between the scapula and humorous, or bone of the 
arm. Then commentaries cannot but be gratuitous, in as 
much as it is so clearly indicated that all those innumera- 
ble useful and indispensible movements of the upper ex- 
tremities depend upon the freedom of these motions. It 
is to be hoped that the answers here given will show sat- 
isfactorily why these points should not naturally be fixed, 
and it would seem that the wisdom in design and the 



SUPPORTER, S3 

munificence in execution in the adaptation of these parts so 
perfectly and fully to supply all our wants and necesities, 
should call forth our most unbounded admiration for the 
goodness and mercy of the divine architect and our bene- 
ficient creator, instead of the stupid question why they 
were not made otherwise. 

But in the process of parturition, the necessity becomes 
as great, and is quite as indispensible, that these points 
should be fixed with a reliable firmness, as it is that their 
motions should be untrammeled to serve the other purposes 
of life for which nature has fitted them. The materials 
with which to fix these centres ofc motion, nature has fur- 
nished in great abundance. She has even been lavish, to 
some extent, both as to numbers and power. It then only 
remains for us to furnish a few simple mechanical supports 
by which these natural powers can be brought into an ef- 
fective action ; then all is done that we can do. And why 
it is that we should have slumbered so long over the fre- 
quent calls for this instrument, can only be accounted for 
by the soporific effects which carelessness and bad advi- 
sors have produced upon our mental faculties. So com- 
pletely had our senses become steeped in the fumes of these 
narcotics, that the mind had become all but caotic on this 
subject. It seems to be cue of those unfortunate omis- 
sions that has passed on unheeded from era to era, and from 
generation to generation, until it would seem to require a 
voice sufficient to awake the antedeluvian dead in order to 
fix the mind upon it again. But once the iiea is broached, 
and has stirred up the mind with sufficient activity to 
dwell upon it for a few moments, it would seem that the 
most verdant tyro in the land might have invented it long 
ago ; and that too, with so slight a mental effort that it 
would hardly be sufficient to disturb the slumbers of a mid- 
summer's day-dream. 



S4 OBSTETRICAL 

To supply these few natural deficiencies, and to enable 
the appropriate sets of muscles with great ease and prompt- 
itude to fix and hold those naturally movable points with 
an unwavering stability, we again offer our Obstetrical 
Supporter. It is a very simple instrument. Its simplici- 
ty, combined with its efficiency, should recommend it at 
first sight. It is easily made, easily applied, and most ex- 
ceedingly easing in all its effects and operations. It even 
surpasses the most sanguine expectations of those who 
laid it before the public. You who have not seen this in- 
strument, do not imagine that it looks any like the cholera, 
the nightmare, or any other frightful or terrific object that 
is calculated to fill us with awe and astonishment. It is 
perfectly mild and inoffensive in its appearance, and a child 
might pick it up without exciting the least degree of fear. 
It never required any superhuman powers of intellect, nor 
a depth of thought that would be likely to rattle dirt into 
their bread and milk on the other side of the earth to in- 
vent, construct, and apply it. 

After the idea once crept through the head, and was 
backed up with the conclusion that it was not fighting a- 
gainst the decrees of Jehovah, or an attempt to counter- 
mand his express ordinations, it then only required a mod- 
erate effort of common sense to do the remainder of the 
work. I have no notion that a man ought to be deified 
for this discovery, and have a place set apart in heathen 
mythology for his special benefit and occupancy ; nor do I 
set myself up as a stump candidate for that honor. After 
having ascertained, as we believe, the philosophical rea- 
sons, as well as the fact, why a female requires her knees 
and back to be held and supported, and also the reason why 
she desires to grasp something firmly with her hands and 
pull so as to make them a fixed and stationary point, then 



SUPPORTED. 85 

the suggestions were easy and rather naturally made as to 
what would be the best mode of supplying those wants ; 
and the grand and primary object has been, from the com- 
mencement to the termination, to go just as far as the re^ 
quirements of nature demanded and there stop short, 
without making one gratuitous addition, the effect of which 
would probably be to perplex and encumber the accou- 
cheur, and annoy if not injure the patient. This would bo 
reprehensible in a tyro, and especially so in one who pre- 
tends to be' an adept in his business. I could have added 
to our instrument, if I had been regardless of the utility of 
its parts, and of every part of it, a spinal supporter, a cru- 
ral suppoiter, a shoulder brace, and night- cap ; also a flag- 
staff and the colors of the United States, and unfurled my 
colors and set them waving on the staff. But after ail this 
show of great things, I should have displayed a much 
greater amount of patriotism than obstetrical know led-: 
The spinal supporter in cur humble opinion would not on- 
ly be entirely useless, but decidedly detrimental; from the 
fact that it would confine, if not entirely destroy or pre- 
vent the motions of the trunk on the pelvis forwards and 
backwards ; consequently we would lose the great advan- 
tage we claim for our Supporter in regard to the ease and 
facility, as well as .the certainty, with which we adapt the 
line of direction" to the axis of the pelvis, so that nododg- 
menc or unnecessary pressure of the head on either side 
shall retard its progress through the superior strait. This 
we claim, and I believe justly so, to be a very important 
part of the beneficial effects of our Supporter, and it must 
be perfectly obvious to every one that a spinal supporter 
would annihilate these benefits zt once. 

A spinal supporter and shoulder brace, (why not a D 
collar and tugs) would inevitably curtail, confine and en- 

H 



OBSTETRICAL 

iwely suppress a great many motions cf the trunk on I 
pelvis, and of the upper extremities, which would be very 
convenient and useful for the patient to make during the 
time of parturition ; being not only useless to the patient, 
perplexing to the accoucheur, but directly detrimental and 
injurious in more ways than one. For these reasons I re- 
jected them without the least hesitation, when suggested 
to me before a patent was procured for our Supporter. The 
determination to attach these things to our Supporter, and 
to use them in that combination, must have been fostered 
and matured b} 7 one of two errors : Either the projectors 
of this fallacy must have been perfectly reckless in regard 
to the utility of their attachment, or its adaptation to the 
v/ants or "calls of nature, and have gone on prompted by 
one single desire, that is, to get up something, no matter 
what, to evade our patent — or else they must have been 
actuated by a most shameful and unpardonable ignorance 
of all the process and mechanism of that labor incident to 
child-birth. Fov no mind of man, in the possession of a 
capacity that would enable the possessor to shun the ordin- 
ary destructive elements, such as fire and water, or with 
a sufficient instinctive knowledge to seek a shelter when it 
rained, would fail for one moment to see the glaring fallacy 
and worse than useless effect of these far-fetched and un- 
scientific attachments, if he had ever accumulated a suffi- 
cient knowledge of obstetrical science to enable him to 
distinguish the pelvis from the cranium. 

What has been said heretofore of our Supporter and the 

natural parts with which it is intended to be connected, and 

to which it is designed to give aid and support, has been 

. J in detached or somewhat remote situations one from 

now proposed to collect the various par^s 



SUPPORTER. 87 

connected form, as they are designed to act in concert with 
each other. Then I shall cease to afflict my friends with 
any further remarks on that subject. 

It was stated in the early part of my remarks, that I had 
two reasons for fixing my extreme point of muscular ac- 
tion at the knees. One of those reasons I explained at the 
time, and dwelt upon it at considerable length ; endeavor- 
ing to sustain the correctness of my preference for the 
knee as the basis of muscular action for the lower extrem- 
ities. The other reason, as was stated at the time, was, 
that I wished to mitigate the sufferings of the female, as 
well as to increase the power of the muscular action, there- 
by shortening the duration of the labor. For this pur- 
pose, that is, to mitigate the sufferings, we have the back 
pad, which is made to fit nicely and sit easy on the back ; 
and I never have known it to cause any trouble or uneasi- 
ness, however great the pressure that was applied to it. 
On a former occas'on it was also remarked that this pres- 
sure was to be applied by the main strap that passes through 
the loops of the back pad ; from thence each extremity of 
the strap takes a forward direction io form two large loop;; 
which pass over the knees ; then the thighs are extended 
on the pelvis until they are stopped and held fast by the 
loops of the main straps. When this motion is brought to 
a stand by the resistance of these loops, into which the 
knees are firmly planted, then all the efforts at ex- 
tension made by the thighs on the pelvis bear directly upon 
the loops that hold the knees, and through the medium of 
the main strap the same amount of pressure is made to 
bear upon the back pad, and holds and supports the back 
just in proportion to the force that is applied by the knees 
to the loops that hold them. We may as well remark in 
this place, what is well known by all who have had any 



OBSTETRICAL 

considerable amount of experience in these matters, with a 
slight degree of observation, that when the head of the 
child is passing the superior strait, and while it is moving 
along the inner and concave surface of the os sacrum, unless 
it is counteracted by an external pressure of an equal or 
a greater amount of force, made from behind in a direction 
forward so as exactly to oppose the internal pressure, that 
this last named force will frequently produce a most ex- 
cruciating, and in many cases an almost insufferable pain 
and torment. Many times there is great pain in the back 
before the head has entered the superior strait, when the 
fundus of the womb is thrown forwards and the mouth 
backwards, and the longitudinal fibres contract powerfully 
to impel the head onward, it is driven against the back with 
great power, amounting to all the contractile force exerted 
by the longitudinal fibres, causing great pain, fatigue and 
suffering, without making the least progress in labor. In 
this case the line of direction must be changed so as to car- 
ry the head from the back and allow it to enter the strait* 
This will relieve the patient, and give an opportunity to 
terminate the labor successfully. 

It must readily be perceived that by carrying these straps 
over the knees, the pressure is made to bear upon the back 
in nearly a horizontal direction ; whereas if these straps 
were carried downward and passed under the feet, so that 
the pressure must be made by the feet instead of the knees, 
so great would be the obliquity of this direction, that the 
unavoidable tendency w^ould be to draw the back pad al- 
most directly downwards ; consequently the force applied 
in this direction would draw the pad away from the back, 
in a line directly towards the feet, so that all the benefits 
we claim for our Supporter by our mode of application 
must inevitably be lost, To prevent the back pad from, 



4 - SUPPORTER. oy 

being pulled entirely from the back, a spinal supporter has 
been attached to that, and a shoulder brace is made fast to 
the upper end of the spinal supporter. This I suppose 
serves as a kind of top-mast to be used only in a light 
breeze. This shoulder brace of course must be lashed fast 
to the shoulders, and these appendages may serve to hold 
the back pad ,per force, from being drawn down to the feet. 
But I do not see how the difficulty is remedied, as far as 
the utility of the pad is concerned ; it certainly could not 
cause the pad to press against the back, and hold and sup- 
port it in a direction to oppose the pressure of the head of 
the child. The remedy proposed for the wrong direction 
which this mode of extension gives to the back pad, I con- 
sider to be worse than the malady itself ; for no mind can 
fail to comprehend what the effect would be. The spinal 
supporter being attached to the back, of course when the 
back pad is drawn forcibly downwards it must carry the 
spinal supporter along with.it, unless that is held by some 
superior counteracting or controlling power. Now let us 
see what the curative process consists of, for this grand dif- 
ficulty ; it seems to be more easily applied than rendered 
effectual, it is this : The shoulder brace is attached to the 
top of the spinal attachment, and the brace is made fast to 
the shoulders, so that # the back pad musi keep its place un- 
less the patient pulls her shoulders down below her hips. 
This remedy however is unfortunately rendered entirely 
inefficient, from the fact that it is not the mere presence of 
the pad in a certain situation that produces its beneficial 
effects, but it must be made, by some force applied to it, 
to press hard on the back in a particular direction ; and this 
pressure and this direction cannot be given or applied by 
the combination and application of the apparatus as above 
described. Of course this puts an end to all that is neces- 

h2 



90 OBSTETRICAL * 

sary to say on this part of the subject. One thing more, 
however, I had intended to have remarked upon ; the 
whole force applied by the feet to the main strap comes e- 
ventually on the shoulders of the patient, and when a great 
amount of force is applied, the effect on the shoulders, the 
chest, and all the upper portion of the body, must be ex- 
ceedingly annoying ; and after they have been repeated a 
few times, accompanied with great exertions, these excess- 
ive inconveniencies must become entirely unbearable to the 
patient. And what is worst of all, these sore afflictions 
are not relieved by a single ray of hope that a beneficial 
effect may be produced thereby. I must say, in conclusion, 
that the only thing that allays my utmost astonishment 
that such a thing should ever be attempted, by those who 
style themselves medical men, is, that the attempt itself 
presupposes an entire ignorance of the mechanism of labor. 
These things might do ad captandum valgus, but they will 
never take among the Doctors. 

The manner in which the back pad of our Supporter will 
hold and support the back, from its shape, and the circum- 
stances connected with its application, the direction in 
which the pressure is made, and the amount of pressure be- 
in * regulated by the will of the patient, renders the utility 
of it perfectly obvious to everyone. It needs only to be 
seen by Physicians, (meaning those who deserve the 
name,) to have its real worth estimated by a clear sighted 
and well-founded appreciation of nearly all its beneficial 
tendencies. Those females who have borne children will 
require no rhetorical charm to be mingled with its des- 
cription, or to embellish its commendation, nor any trum- 
pet-tongued eulogiums to convince them of its utility or 
the practicability of its powers to relieve them. Sad ex- 
perience has taught them its true value, and in their judg- 



SUPPORTER. 91 

merits, based upon experience, they will prize it far above 
the gold of the modern El dorado, or the oriental gems 
of the first water. 

Another important part of our Supporter is the main 
strap, which passes from the back pad in a forward direc- 
tion, exactly over the hips ; and they also receive a firm 
and very grateful support from the strap. The ends of the 
strap again approximate the back pad and are united to 
the strap as it passes down the thigh, in such a way that 
they sit perfectly smooth and easy on the thigh ; this un- 
ion forms two loops of sufficient capacity to receive the 
knees and fit nicely to them. The knees then being the 
distal extremity for the insertion of those muscles which 
have their origin from the different points of the pelvis, and 
are des'gned to fix and hold it while the abdominal muscles 
contract and pull upon the superior points of the pelvis in 
the act of paturition. 

It seems almost a w^aste of time to remark in this place, 
the idea is so naturally suggested, that it is worse than use- 
less to fix the point to which we apply our support below 
the knees; it would certainly complicate the machinery to 
an unwarranted degree, by bringing into action a great num- 
ber of muscles which have no direct connexion with the 
work to be accomplished. The most obvious and natural 
result of this commingling together of those parts dissimi- 
lar in f unctions and operations, forming a kind of hetoroge- 
nious complexity of the useful with the useless and una- 
vailing exertions, will be to w r eaken if not destroy the ef- 
fective efforts of those agents on which, if allowed to act 
by themselves, we might confidently and safely rely to ac- 
complish the objects for which w x e employ both the natur- 
al and artiacial parts. I believe that simplicity, combined 
with utility, is so far desirable that it is almost universally 



92 OBSTETRICAL 

sought for, and is a commendable quality in all instruments 
and mechanical structures ; and with this principle in view 
we should always simplify to the full extent that we can 
go, without a positive redaction of power in the essential 
parts, or curtailing the utility of the instrument or ma- 
chinery. The knees then are firmly planted in the loops 
of the main straps, followed by an extension of the thighs 
on the pelvis until the loops of the strap prevent the efforts 
at extension from going any further. Then the loops re- 
ceive the effect of all the extensor muscles of the thigh, 
and they serve {he double purpose of giving an easy and 
ample support to the knees, and at the same time the pow- 
er applied to them is conveyed to the back through the 
straps, and is all that can be asked for or given in the way 
of a most grateful and all -sufficient support to that part. 
In all this operation it will be seen that the patient is the 
sole actor in the w T hole drama ; if she is sitting she is not 
drawn off from her seat ; if she is lying she is not disturb- 
ed in her position. She supplies the powder by which the 
knees are held and the back supported ; and this too is 
done by a simple effort that is peremptorily demanded to 
hold the pelvis in its proper position ; and the pressure on 
the knees and back may be greater or less at the volition of 
the patient. Now all this work that was once complica- 
ted, mysterious, crude and uncertain, is carried on with an 
ease and simplicity, a quietude and neatness, that cannot 
fail to call forth the approbation and lead captive the good 
taste of every well-balanced mind that is based upon sound 
judgment. And the systematic co-operation of all its parts, 
combined with its regularity and reliable certainty, can on- 
ly be excelled by the harmonious revolutions and equi-dis- 
tant motions of the heavenly bodies, whose equalibrii ar3 
sustained by an Almighty power. 



SUPPORTER. 93 

The muscles which perform this part of the work, and 
fire connected with the lower extremities, and the applica- 
tion of the back pad and main strap of the Supporter, 
having their rise from some points of the pelvis, and 
their insertion into the cervix, trochanters and staff of the 
thigh bone and into the head of tibia and fibula, are the 
pectinalis, the triceps adductor femoris, the adductor lon- 
gus femoris, the adductor brevis femoris, the adductor mag- 
nus femoris, the obturator externus, the gluteus maximus, 
the gluteus medius, the gluteus minimus, the pyriformis, 
thegemelli, the quadratus femoris, the sartorius, the graci- 
lis, the rectus femoris, the semitendinosus, the semimem- 
branosus, the triceps flexor cruris, the iliacus internus, the 
obturator internus, the psoas magnus. When the efforts 
of the extensor portion of these muscles are brought to a 
stand by the loops of the Supporter in which the knees are 
planted, which prevents the action of the extensors pro- 
ceeding any further, then these muscles all contract on 
themselves — they become very hard and rigid, and by their 
inherent and contractile force they pull very hard upon 
each pcint of their attachment, which by a reference to the 
description I have given of them in a former part of this 
work, will be found to be on some inferior or depending 
portion of the pelvis on the one hand, and some point of 
the thigh bone down to the knee, and into the heads of the 
two bones forming and being near the knee joint on the 
other. Now nothing can be more certain or less obnox- 
ious to contradiction, than the fact that when these mus- 
cles contract in their muscular centres, and pull hard upon 
these points of attachment, that they will fix. firmly and 
almost immovably the pelvis on the thigh bone ; and this 
js one of the principal or grand designs of our Supporter. 
To antagonise these muscles, and to act nearly in an op- 



94 OBSTETRICAL 

poslte direction, and apparently to balance the action of 
the abdominal muscles, and to act in the same direction 
with them, we have the quadiatus lumborum and the 
psoas parvus ; these are attached by one extremity to the 
spine, and the other tc) the posterior half of the pelvis. 
While the abdominal muscles act in an anterior and supe- 
rior direction, these muscles act in a posterior and superior 
direction. These two sets of muscles hold a balance of 
power to some extent, and by their co-opeialive contrac- 
tion the superior portion of the pelvis is held in a more 
steady, firm and well balanced position, The abdominal 
muscles have somewhat the proponderence in respect to 
power, and this is necessary to overcome the natural ob- 
liquity of the pelvis forwards and downwards. It is impor- 
tant for the abdominal muscles to act in a direction to raise 
the anterior part of the pelvis, and to bring the trunk for- 
ward so that the line of direction indicated by the child's 
head from above downwards, shall cut a horizontal line on 
the brim of the pelvis or superior strait, at right angles. 
When these regulations are systematically arranged, and 
all the parts brought into and maintained in their proper 
and relative situations, then the head will enter and pass 
through the superior strait without crowding so hard on the 
bones of either side as to prolong the duration of labor 
twice or thrice the length of time that would be required 
if every thing wr.s properly conducted. In this day of 
light and knowledge, a failure by a physician to make the 
required observations, or a neglect to apply the proper 
means and give the necessary direction to secure such a 
position and relative situation of all the parts as will tend 
most directly and systematically to facilitate the great work 
of a safe and expeditious delivery, shows an amount of 
ignorance in his profession that may seek in vain for a valid 



STJPFOKTES. 

excuse, and ought to paint his cheek in a crimson dye that 
no bleaching agent can remove. Or, on the other hand, 
it shows a recklessness and desperation that is regardless 
of the lives and well-being of their fellow creatures, and 
betrays a breach of confidence and good faith reposed in 
them by a confiding community, that ought to be deemed 
a good cause to expel them from the pale of the profession, 
and effectually cut them off from all privileges and com- 
munion with the medical word. 

We will now proceed to fix the superior extremities of 
those great voluntary agents which nature employs in the 
work of parturition. The artificial parts, or those which 
we propose to supply from the Supporter, to aid in this de- 
partment of the work, are the handles of that instrument. 
It will be recollected that these are attached to the knees 
by straps passing through loops of the movable knee pads. 
The handles are made fast to each end of these straps and 
lay transversely across the thighs, a little above the knees. 
The patient grasps these handles firmly with the hands, 
then the flexors and extensors of the hand and forearm con- 
tract and fix the forearm on the hand, and in the same 
manner with another set of muscles the arm is fixed on the 
forearm. Then those muscles which have their origin 
from the different prominences and projections of the sca- 
pula, and their insertion into the bone of the arm or 03 
numerous, contract and fix the scapula on the arm. A 
description of these muscles may also be found by referring 
back to the description of muscles. They are the supra- 
spinatus, the infra- spinatus, the teres minor, the teres ma- 
jor, the deltoides, the coraco brachialis, the sub-scapularis, 
the biceps flexor cubiti, the triceps extensor cubiti. When 
thes3 muscles contract to fix the scapula on the arm, they 
1 ~:ve a tendency to draw the scapula downwards and for- 



96 OBSTETRICAL 

wards ; and this calls into action another set of muscled 
which exert their contractile power to prevent the scapula 
from being pulled out of its place. They are situated on 
the posterior and superior portion of the thorax. These 
muscles have also been fully described in rotation, as they 
occurred in the description of muscles. They are the tra- 
pesius or cucularis, the latisimus dorsi, the rhomboideus, 
the levater scapula. These muscles do not directly antag- 
onise the former set in the direction of all their fibres, but 
they do it sufficiently to make a fixed point of the scapu- 
la, which usually moves with great ease. The contractile 
efforts of one part of these muscles are directly opposed to 
the former set, and the remaining part of them act in a line 
of direction which forms an angle with the others, more or 
less approximating a right angle according as their several 
lines of direction decussate each other. 

This brings us to the points of attachment for the su- 
perior portion of the abdominal muscles, which are the ribs 
and sternum and the cartilages that belong to them both. 
When the abdominal muscles contract, they must of course 
pull upon the ribs and sternum with a tendency to draw 
them downwards, or downwards and backwards ; this will 
stimulate another seL ul muscles, and cause them to con- 
tract and resist the effort to draw the ribs and sternum 
downwards. This set of muscles are those situated be- 
tween the ribs and sternum and the scapula, and between 
the ribs, sternum and cartilages and clavicle or collar bone. 
The scapula, it will be recollected, when these previous sets 
of muscles are in a contracted state, is a fixed point ; and 
consequently when those muscles contract firmly, they will 
fix the ribs and sternum to the scapula and clavicle. These 
muscles will be found among those we have described in 
the former part of this work. They are the pectoralis ma- 



SUPPORTER. 97 

jor, the sub clavius, the pectoralis minor, the serratus mag- 
nus, the triangularis or sterno-costalis. These muscles are 
-also very much assisted by the action of the intercostalis 
externi and the inlercostalis interni. When these muscles 
-all act, as they will when any force is exerted which has a 
tendency to pull one rib from the other, they bind ail the 
ribs firmly together, so that when the other muscles act 
only upon a part of the ribs, by the aid of the intercostal 
muscles all the ribs are held with equal firmness and se- 
curity. 

This completes a series of fixed points from the hands to 
the ribs and sternum. It forms a grand chain cable, stretch- 
ing from one of.these points to the other, and no pains has 
been spared to describe every link in this chain with that 
perspicuity, simplicity and truthfulness^ that will enable 
every person to comprehend, by this view of the component 
parts, the real utility of the whole connexion. When this 
is understood, the philosophical principles on which the 
Supporter must inevilably contribute largely to the comfort 
and relief of the female, are as clear as the cause of that 
effect which is so often made manifest to us, and with 
which our visual organs have become so familiar, (i. e-.) the 
effulgent rays of heaven's bright luminr ich dispels 

the darkness and gloom that had previously hung over ue. 

As I leave this part of my subject, permit me to say, if 
my arguments have been clothed with an ambiguity that 
cannot be penetrated by common minds, or if I have un- 
fortunately blundered upon wrong premises, so that my 
inferences and conclusions must fall to the ground, it 
all be attributed to a want of skill or a lack of argumenta- 
tive power; for I have labored long and hard to be both 
correct and comprehensive, beyond the power of the logi- 
cian to set aside. 

j. 



OBSTETRICAL 

The two paints of attachment for the abdominal muscles 
being now fixed with a sufficient firmness and strength of 
material to hold them against the powerful efforts of those 
muscles to move them, It now only remains for the abdom- 
inal and respiratory muscles to exert their inherent pow- 
er, given them by the Almighty and Omniscient Architect 
of all things, to finish the work that now only awaits their 
exertions for that purpose. 

At the commencement of the voluntary efforts of labor, 
and aftsr the os uteri has been fully dilated, the Supporter 
may be applied with a full expectation of receiving great 
benefit from its operation. The Supporter is applied ex- 
ternally to the clothes, so that no exposure or any other 
inconvenient or objectionable operation arises from its use. 
The back pad is applied over the region of, or opposite to 
the pressure of the child's head. This very much re- 
lieves or entirely suspends this very troublesome and many 
times excruciating pain. The loops of the main strap are 
then carried forward and passed over the knees, always re- 
membering to adjust the sliding pads to the knees — this, 
in connexion with the muscles, fixes and holds fast the in- 
ferior or depending portion of the pelvis. Then the pa- 
tient grasps the handles, (and would do so instinctively if 
she was not told,) and through a continued chain of con- 
tractions fastens the ribs and the sternum. Simultaneous- 
ly, or a little preceding the last named efforts, the patient 
takes a full inspiration, which presses down the superior 
arch of the diaphragm, which converts this vaulted mus- 
cle into an inclined plane, commencing at the ziphoid car- 
tilage and passing obliquely backwards and downwards, 
the lower portion descending as far as the inferior dorsal or 
superior lumber vertebra. From this powerful and entire 
inflation of the lungs, by this long and full inspiration, and 



SUPPORTER. 9S 

the consequent firm pressure of the lungs up©n the dia- 
phragm, the plain thus formed is rendered quite firm and 
unyielding to the pressure that is made upon it. Then the 
abdominal muscles contract, (as may well be supposed from 
their size and power,) with a force that will overcome al- 
most any opposition ; and, as heretofore shown, both the 
points of attachment for these muscles are now fixed with 
firmness and stability, and these muscles can exert all their 
contractile power to the very best advantage that nature 
and art can afford them. The great ani invaluable advan- 
tage to be gained by the stationary and stable position of 
these points, grows out of the fact that the power of these 
muscles is greatly increased, and their action is guarded 
and sustained by the greatest economy, so that nothing is 
lost of all the effective power that they are capable of ex- 
erting. 

When this contraction takes place in a proper manner, 
by the abdominal muscles, another plain is formed, though 
not exactly parallel with that formed by the diaphragm, 
yet from the manner in which the space between the two 
plains is occupied, they are sufficiently parallel for all 
practical purposes. The obtuse angle formed by the spine 
and the junction of the diaphragm with it, is, during the 
time of child-birth, occupied and filled with the abdominal 
viscera ; so that the uterus comes directly in contact with, 
and under the influence of, the abdominal muscles. 

The womb is then pressed with great force, and by ma- 
terials every way calculated to bring about the desirable 
end, between the plains formed by the abdominal muscles 
and the superior portion of the diaphragm. The uterus is 
compressed with a firmness, a power, and an adaptation of 
material, that was planned and executed by a higher pow- 
er and a more far-seeing wisdom than was lately displayed 



■TOO OBSTETRICAL 

in the application of a pad to these parts. Who can now* 
fail to discern that from the manner in which the recti 
muscles will contract, (i.e.) bj seperate or independent 
sections,they will almost embrace the fundus of the womb ; 
find that this voluntary contractile action must necessarily 
afford great assistance to the efforts of the longitudinal 
fibres of the womb to overcome the resistance made by the 
circular fibres- to retard the passage of the child. These 
contractile efforts put forth by the recti muscles, in con- 
junction with the same powers exerted by the longitudi- 
nal fibres of the womb, enable them to approximate the fun- 
dus towards the mouth, and consequently the contents of 
the womb must be expelled. These are all plain, easy, 
straight forward, arid natural operations ; there are no con- 
tortions nor circumlocutions to mislead the unwary, or to 
.hide an error, however small it may be. Thus it may be 
seen that in proportion as the power or effective operation 
of these muscles are brought to bear on the womb, in the 
same ratio the labor must be facilitated. 

Perhaps I may as well remark in this connexion, that if 
any person is disposed to doubt the truth or validity of my 
arguments, and the assertions which I have ma are with re- 
gard to the functions and the labor performedVas connect- 
ed with the work of parturition, by the various sets of 
muscles which I have described, they have only to exam- 
ine the condition of these muscles while in that situation, 
ia which I have represented them as performing certain 
actions by virtue of their inherent contractile powers, and 
if they do not find them hard and unyieldingly rigid, and 
under the influence of a very powerful contract ibilitj, then 
I yield the point. But if they find them in this condition, 
then I claim that they perform every thing that I have as- 
signed them in the voluntary depaitment of parturition, 



SUPPORTER. 101 

and take it for granted that my arguments stand upon a 
firm basis, and are sustained by a fair and unequivocal de- 
monstration. My candid opinion is, although it may not 
be of much value, that the time of any one would be far 
more advantageously spent by endeavoring to improve on 
the rules and principles here laid down, than by a fruitless 
and unavailing attempt to controvert or disprove them. 

Then if I have proved to the satisfaction of my readers, 
and I think it can hardly be otherwise, that by the aid of 
our Supporter we increase the effect of the contractile 
power of the abdominal muscles, then so far we claim, and 
even demand, credit for the beneficial effects of the Sup- 
porter. We now ask, as an equitable claim for the Sup- 
porter in the nature of benefits entire, or as beneficial aid 
afforded to the natural parts concerned in the process of 
child-birth, the following specifications : 

1st. That it mitigates the sufferings of parturient fe- 
males, from the manner in which it holds and supports the 
back, and thereby counteracts the pains and sufferings 
which are produced by the pressure of the head upon the 
internal surface of the back. And I wish it to be recol- 
lected that this pad may be used in all cases, no matter 
how great the tenderness and irritability which has previ- 
ously existed. So nicely is the cushion of the pad adapt- 
ed to the back that it yields a most ample support, unat- 
tended with the most remote probability of doing an in- 
jury. I never have known a solitary instance where any 
inconvenience has been experienced from the use of it. 
I have known a number of cases where the patient would 
object to its application under the impression that it would 
increase the irritability then existing, but directly on the 
application of the Supporter, the pain in the back would 
be o;reatlv relieved or entirely cease. 

i2 



102 OBSTETRICAL 

2d. That the entire ease with which we can adapt the 
;ngle of direction to the axis of th3 pelvis in a right and 
roper manner, enables us to proceed without the loss of 
:ny pains ; and so perfectly simple and easy is the method 
)f doing it, that no accoucheur is at all excusable if he 
leglects to avail himself of this important benefit. He 
las only to direct the patient to grasp the handles of the 
nipporter^ and if the head is thrown forwards and strikes 
n the os pubis, as is most commonly the case from the 
natural obliquity of the pelvis forwards and downwards, as 
I have before described, then direct her to pull herself for- 
wards by the handles — this will carry the fundus of the ■ 
vvomb forward, and give the head a backward direciion, 
and if skill and care be used, the line of direction on which 
the head descends may be made to intersect the horizon of 
the pelvis at right angles, ceteris paribus } the head will 
enter the superior strait and pass on. If, on the contrary, 
as sometimes happens, the head is thrown backwards and 
strikes the prominence of the os sacrum, then direct the pa- 
tient to extend her arms and move herself backwards, 
which of course will carry the fundus of the womb in the 
same direction, and give a forward movement to the head ; 
this will dis'odge it from the sacrum, and with the same 
precautions, it will move on as before. 

If the head does not become firmly fixed on either of 
ihese points, it is quite frequently the case that such is the 
)'oliquity of the pelvis, or the direction in which the head 
lescends, that it presses so hard on one or the other of those 
•oints that it will very much retard the advancement and 
•rolong indefinitely the duration of labor. It is not ne- 
essary for me to repeat the manner and the ease with 
vhich the head may be made to enter the superior strait at 
'ght angles, with the brim of the pelvis. When these 



SUPPORTER. 103 

liings are properly attended to, no pains are lost, and much 
suffering is prevented. Experience has taught those fe- 
males that something must be done to overcome the natur- 
al obliquity of the pelvis ; hence it is that old ladies who 
have borne children and been frequently with others, will 
direct the patient to draw down or curl under her chin 
when the pain comes on ; and by this motion of drawing 
dow r n the chin she carries herself forward, and very imper- 
fectly performs that which the Supporter does in great per- 
fection. Although the good old lady has no definite notion 
why she gives her advice, except that she has found relief 
from it, nevertheless the idea is a good one, and based on 
sound philosophy, and I have no hesitation to quote it as 
good authority for many of the directions which I have 
previously given ; and I have as good authority for the 
correctness of the principle as Prof. Meigs, of Philadelphia. 
I heard him advance the same remark in one of his lec- 
tures. 

3d. That by the aid of the Supporter, we positively 
shorten the duration of labor, by enabling the proper sets 
of muscles to fix the two points of attachment for the ab- 
dominal muscles, thereby enabling them to exert the 
whole force of their contractile power, without loss or 
hindrance of any kind, for the expulsion of the foetus from 
the womb. 

The operation of the Supporter in this respect is to en- 
able the voluntary muscles to perform that part of the la- 
bor which the God of Nature designed them to do, instead 
of leaving the whole of these almost superhuman exertions 
to be performed alone by the organic or involuntary mus- 
cles. N'ow if there ever was a case under the broad cano- 
py of heaven that called loudly for the utmost exertion of 
every agent endowed with a capacity to lend a helping 



104 OBSTETRICAL 

hand, it is that of child-birth ; and as far as my knowl- 
edge extends, there is no labor required of human nature to 
perform so directly calculated to prostrate the whole en- 
ergies of the system. 

I shall not dwell upon the branch of our subject now 
under consideration, in this place, for the reason that I 
have discoursed upon it at great length elsewhere ; and if 
one will not be convinced after all I have said and demon- 
strated on this part of the subject, they would not believe 
though Moses and the Prophets should appear and verify 
my sayings. 

4th. That we may entirely dispense with the aid of any 
assistants, as the Supporter will do all that can be done by 
the greatest number of them that could be gathered a- 
roundthe patient ; and what is of still greater importance, 
do it a thousand times better. A nurse to take care of the 
mother and child after delivery, is all the help we need, 
and all that is required to be in attendance ; unless the pa- 
tient should require the presence of some near and dear 
friend to sooth her in this hour of tribulation, which some- 
times tries the fortitude of both patient and physician.— 
This however is the true province of the attending phy- 
sician, and if he is a gentleman, and has his heart in the 
place that every member of the profession should have, he 
will never neglect or allow an opportunity to pass unim- 
proved to sooth and comfort the poor sufferer by the most 
kind, sympathising and encouraging language that he is 
master of ; and he may rest assured that such conduct will 
never be forgotten by the recipient, and it will revive and 
restore her crushed and drooping spirits, like the kindly 
dews that are distilled from the benign heavens above us 
on the parched and withered plant — so that the patient is 
not only relieved to a very great extent from her pains and 



SLTPORTER. 105 

sufferings, but a very considerable amount of toil, patience 
and trouble is saved to the assistants ; and this to many 
feeble and delicate females has proved the cause of a severe 
and sometimes a protracted case of illness. Even this 
latter benefit, isolated from all the others, would materi- 
ally interest nearly the whole female portion of any com- 
munity, and should enlist their influence for the adoption 
and general use of the Supporter ; and when its whole op- 
erations are known, it never can fail to produce that re- 
sult. 

5th. That the Supporter is not only entirely safe to the 
mother and child, but it adds to the safety of the mother to an 
extent that has never yet been fully appreciated ; and this, 
to my mind, and to every mind duly impressed with a just 
sense of the weighty responsibility due to its fellows and 
to its God, is no trifling recommendation, but one that 
should favorably impress the mind and judgment of every 
person who justly appreciates the value of human life. In 
my opinion, it ought to be*the watchword of every plvysi- 
cian in the land, that we should always, without excep- 
tion, use those means that are known to be safe, and such 
as will increase the safety and lessen the danger of those 
who confide with an unwavering hope in our skill and phi- 
lanthropy. 

From the earliest time in which I was iniatiated as a no- 
v-iate in that noble, philanthropic and almost God-like art 
of healing the sick, down to the time of penning thes e 
thoughts, the idea was irrevocably and most solemnly im- 
pressed on my mind, that the true science of medicine, 
when faithfully studied, perfectly understood, and wisely, 
judiciously and carefully administered in its application to 
practice, was one of the great and prominent mercies of 
God to man, and through His, unbounded goodness it was 



106 OBSTETRICAL 

bestowed on us to lessen the dangers naturally incident to 
human life — to alleviate our pains and afflictions — to eke 
out the span of human existence ; and, from its source, as 
well as from the principles it inculcates, I have ever look- 
ed upon it as one of the noblest sciences that ever the ca- 
pacious mind of man was enabled to embrace or compre- 
hend. 

With these exalted ideas of this pre-eminent science, I 
also imbibed another, to me very natural impression, which 
was engraved on my innermost soul with indelible materi- 
al, viz., that the great, grand and fundamental principles of 
this science were embraced in these few words : 6i Visit 
and administer with care, skill and prudence to the sick and 
afflicted — cure and prevent disease by every laudable and 
safe means that sound reason or true philosophy has sug- 
gested to your mind — endeavor, at all times, when called 
upon, to aid the agonizing struggles of nature to free her- 
• self from the fangs of disease, by every safe and expeditious 
remedy that the munificent hand of God has so abundantly 
strewed in your pathway." These principles, according 
to the views of your humble servant, are a kind of multum 
inparvofiT cornucopia, from whichmaterials may be drawn 
to rear the whole grand superstructure of that proud science 
of medicine which has descended from our ancient and dei- 
fied worthies. So strongly have these principles entwined 
themselves about my memory, that I shall probably never 
be able to rid my mind of the impression that the safety of 
the patient, (or those who intrust their lives and health in 
our hands,) should stand in the frontrank of all our endea- 
vors for the restoration of health, or the mitigation of pain 
and suffering ; and that safety is the key-stone in the sub- 
lime arch of the healing art. 

Being of that school of politicians that are not frightened 



SUPPORTER. 107 

at responsibilities, I take it upon myself to say, that no man 
has a right, that may be inferred either from religion, mo- 
rality or humanity, which are taught from the word or in- 
spiration of God, or from the principles, rules or philoso- 
phy which are taught in the science of medicine, to use 
dangerous and destructive articles in the curative process 
within the province of the physician ; or to use doubtful 
remedies, the operations and effects of which are not per- 
fectly well known and scientifically established on the most 
reliable basis ; or to use those remedies, the effects of which 
are not to be depended upon, being erratic, eccentric and 
dangerous, from the fact that they are governed by no fix- 
ed laws or established principles on which a safe and phi- 
losophical calculation might be based : hence, every endea- 
vor to effect a specific object with these things, would be 
like the efforts of the blind man to comprehend light. 

Whoever so far forgets the dignity of his station as to 
make use of these unsafe, uncertain and uncontrollable re- 
medies, fraught with treachery and danger, degrades his 
calling, and descends to a level with the empirical ignora- 
mi : he is out of the pale of his profession, and has over- 
stepped the farthest landmark that gives bounds to the 
most liberal construction which ma} 7 be put upon the most 
favorable rule or principle inculcated or put forwards in the 
whole science of medicine. The station in life held by the 
man who indulges in the use of these forbidden fruits of the 
profession, does not alter the case at all : if I take a club, 
gilded and ornamented in the most splendid manner, and 
beat a man's brains out with it, I am equally amenable to 
an outraged law as if my club had been simply 'rough and 
ready. 5 It matters not whether a man is wise or simple, 
noble or ignoble : ' the Ethiopian cannot change his skin' — 
he is battering down the pillars that uphold the venerable 



1 08 OBSTETRICAL 

temple reared with so much care by the wisest and best men 
of the profession in all ages of the world. Safety, I repeat, 
is the polar star, and of the first magnitude in that heaven- 
guarded constellation composed of the brightest spirits that 
ever shed light and glory upon the medical world ; and the 
eye of the good physician will ever be fixed upon it, and if 
his compass is made of the right materials it will direct 
him to that star with the same unerring certainty that the 
magnetic needle, though far away on-the ocean-wave, will 
point to the mysterious chambers of the north. 

When called upon by an afflictive dispensation of a wise 
through inscrutable Providence, to administer to the sick 
or to perform an operation on the afflicted, that star should 
be in the ascendant, and our conduct be regulated thereby. 
Hence the first enquiry that will present itself for our con- 
sideration will be, what is the safest course to be pursued 
for the benefit and restoration of this patient? And when 
settled by a scientific knowledge of the disease and the 
proper remedy, the next thing presented for our considera- 
tion and determination will be, what is the most expedi- 
tious mode to accomplish the same end ? And when this is 
settled upon, we should prayerfully invoke the blessings of 
heaven to aid the efforts we may put forth for the recovery 
or the comfort of a fellow being. When this is done with 
that faith which will ever make works effective, we may 
commence our labors with every human probability of suc- 
cess. Would to heaven that this was a universal law by 
which every member of the profession was governed 
throughout the wide universe or God! 

These rules and principles have been laid down as 
landmarks and beacons for our guidance, as pilots while 
steering the ship of practice through that ocean of science 
that has for its object the perfection of the healing art, by 



SUPPORTED. 109 

fevefy work on therapeutics that has ever emanated froth 
the light-giving bodies of our profession since the setting 
of that star that presided oyer the life of the venerable 
and deified Hippocrates. 

The same wholesome laws and righteous principles have 
been promulgated from the desk of every Professor where 
your humble servant has been so fortunate as to be a lis- 
tener ; and he has treasured them up in the archives of his 
memory as things never to be forgotten, with the same 
veneration as did the'worshippers of Apollo the predictions 
of the great Oracle at Delphi, And they have been hand- 
ed down to us for imitation, clothed with a garb made sa- 
cred by the experience of ages on ages. These ancient 
and time-honored maxims have been distilled from the lips 
of the hoary-headed sages in our profession, who have 
grown gray in a long and honorable life, spent at the bed 
side of their patients, who have been gathered to their 
fathers as a harvest fully ripe, and have bequeathed us 
these heaven- approved principles, which, if heeded, will 
fall upon us like Elijah's mantle, and shield us from a thou- 
sand sins and follies. They should ever be to us like the 
oracles of ages speaking from the tombs that hold the dust 
of greatness and wisdom. I appeal to the sober second 
thought, to the cool and deliberate reason, io the calm, 
profound and philosophical judgment of every noble, w r ell 
balanced and philanthropic mind, the whole wide w T orld 
over, if the side of safety is not the shore on which every son 
of good old iEsculapius should arrange himself if he desires 
the approbation of Heaven and the good will of his fellow- 
men. The minds and souls of those great and good men, 
the source from which these principles have emanated, are 
as high above the novel but gilded butterfly toys of the 
shallow-brained, barren-minded empirics, whose highest 



110 OBSTETRICAL 

aspirations of ambition are to captivate the vulgar by seme 
little wonder-working incantation, or temporary insensibil- 
ity, as those soul-cheering beams from heaven's grand lu- 
minary are superior to the insignificant glow of the solar 
phosphori that excites the nocturnal wonder of the poor 
nervous school-boy. 

Some have wove themselves a kind of arachnoid mantle 
to shield themselves from the frowns of an incensed com- 
munity, if their folly should prove fatal to its recipients, by 
saying that the patient had called for the suspender of vi- 
tality; but that covering is too thin altogether. Suppose 
they did call for it — they are not the proper judges, at such- 
times, of the danger or safety of a remedy. I have been 
appealed to, often and again, in the height of the most ago- 
nizing torment, to give them something to put them to rest 
or kill them at onee. Suppose the patient should tell you 7 
while in a slate of misery amounting to a degree of suffer- 
ing to which death seems, for the time being, by far the 
most preferable, to take a razor and cut her throat. Would 
that shield you from the retributive justice of the broken 
and outraged laws of your country ? Would it dry up the 
tears, and hush to slumber the cries and groans of the near 
friends and dec*r relatives of the deceased ? Would it be a 
valid excuse or a reliable shield to allay the ire or turn 
aside the unerring shaft of offended justice, or the devour- 
ing judgments of that all-powerful but seemingly disregar- 
ded God, who has devoted an entire commandment in his 
decalogue to the great law-giver, to say unto man, " Thou 
shalt not kill" ? Better for the man who should commit 
this, or a similar wickedness, that a mill-stone had been ti- 
ed to his neck, and he cast into the midst of the great deep. 

A physician has no license to be a gambler, and human 
life is not a proper material to stake on a game of chance- 



SUPPORTER. Ill 

for the reason that, if it is lost, it can never be made up or 
restored. If we must indulge in a kind of professional gam- 
bling, let us do it theoretically instead of practically : theii 5 
we may lose our reputations, but not the lives of our pa- 
tients. In this case we shall use our own funds instead of 
borrowing that which we have no means under the heav- 
ens of paying. Let us never presume to experiment with, 
or foolishly employ those agents, the tendency and effects 
of which are known from past experience to be dangerous. 
And when I speak of damgerous remedies, I do not mean 
those that are known to be fatal at all times ; but if former 
trials, either of our own or tbose of others, that have come 
to our knowledge, have demonstrated to our satisfaction 
that from the administration and baleful effect of an article 
a few have died and a great many have escaped from 
its fatal consequences, this ought to be sufficient, for phy- 
sicians at least, to let it alone. It is certainly not very be- 
coming in us, who are the guardians of the lives and health 
of those who confide in our skilly and trust implicitly in our 
friendship, and have set us in the watch-towers of that sci- 
ence whose ostensible purpose is io give warning when dan- 
ger approaches, to make the experiment and see who are 
the unfortunate ones that are to die^ or the fortunate ones 
that are to escape death, under the use of a remedy, the ef- 
fects of which are, to suspend, for the time being, the whole 
vital energies of the nervous system. Because a person 
may be in danger and escape immediate death, does not ren- 
der it desirable to„those who have an ordinary degree of pru- 
dence, to rush, heedless of consequences, into those places 
fraught with danger and with death. 

Bonaparte crossed the bridge of Lodi under a most tre- 
mendous and galling cross-fire of his enemies, which dark- 
ened the noon-day sun, and made the atmosphere rife with 



1L3 OBSTETRICA-! 

balls and grape-shot ; — yet he escaped with his life.—* 
But does that render it a suitable place of resort for a physi- 
cian to recommend to his patients for their health ? Gene- 
ral Taylor escaped from a. number of well and hard -fought 
battles on the plains of Mexico, where many a brave sol - 
dier fell by his side to rise no more till aroused by the sound 
of that angelic trump that shall awake the slumbers of the 
grave. On these sanguinary fields, where death finds his 
harvest amid the clash and clang of mingled armor, sounding 
in mortal combat, where the missiles of death flew swiftly 
and thickly around him like the silent messengers of fate to 
invite the spirits of heroic men to the fields of another world , 
the old hero stood erect among the ruins they had made 
around him, with his undaunted eye beaming confidence of 
success. Some of these death-dealing messengers, howev- 
er, had the audacity to carry away the breast-work of the 
old brown coat, but there was no surrender. And yet Gen- 
eral Taylor escaped unharmed from all these impending 
clouds of desolation, whose portentious frosts seemed to 
threaten immediate death and annihilation. But few of us, 
I think, would.be particularly anxious to make the experi- 
ment in order to ascertain whether we would be alike for- 
tunate with the general. Perhaps I have taken up too much 
time on this branch of my subject ; but I consider it of vast 
importance that the community should know where danger 
is concealed, and that they should also understand that an 
escape from danger is not a destruction of it, but the dan- 
ger may remain to take deadly effect on them at another 
time. 

I have said that our Supporter adds to the safety of the 
patient, and now I will endeavor to show wherein. We 
shall take it for granted (certainly till the contrary -is shown) 
that it has been proved beyond controversy that our Instru- 



SUPPORTER. 113 

ment increases the power and efficacy of the voluntary mus- 
cles that enter directly into the labor of child-birth. In 
connection with this, another fact presents itself, of equal 
importance and perspicuity : it will not be disputed, if the 
former is admitted, that the Instrument will lessen the la- 
bor for the involuntary, in the same degree that it increases 
the operative power of the voluntary muscles, which, with- 
out this, or something similar to support them, are almost 
a dead-letter in the whole operation. It follows, then, as 
effect follows cause, that if a good proportion of the labor 
is thrown upon the voluntary department, it will relieve 
the uterus from the same amount of toil, and instead of 
throwing the whole upon the womb to be performed by that 
organ alone, which must necessarily waste its strength and 
exhaust the vitality and contractibility of its fibres, and there- 
by render it incapable of contraction after the expulsion of 
the child. It is greatly assisted by the voluntary muscles, 
both as to the amount of labor it has to perform, and in re- 
spect to the time it is compelled to keep up those powerful- 
ly contractile efforts. The result of all these contractile ef- 
forts from the voluntary system, rendered salutary and ef- 
fective by the aid of the Suppoiter, enables the womb to 
come out from the work active, vigorous and strong, hav- 
ing the power of a ready and voluntary contraction, or very 
easily excited to the same after delivery. 

Now I presume it is well known to every accoucheur in 
the land, that one of the great, if not the greatest causes of 
danger and death attendant on child-birth, is a uterine he- 
morrhage after the separation of the placenta from the 
womb, or a partial separation accompanied by a flaccidity 
of that organ, -and an inability to contract upon itself with 
sufficient firmness to compress the bleeding surface so as at 
once to prevent the hemorrhage. In speaking of hemor- 

j2 



114 OBSTETRICAL 

rhage in this place, reference is not had to the unavoidable 
hemorrhage that takes place more or less when the placen- 
ta is attached to the cervix and os uteri : this takes place 
prior to the delivery of the child, and depends upon other 
causes than those I refer to above. 

It is more than probable that the whole number of deaths 
from hemorrhage after delivery, has never been known to 
the profession at large. Doubtless many deaths have oc- 
curred from concealed hemorrhage, w T ith the young and in- 
experienced practitioner, who has failed to detect the cause 
himself, or has neglected to make it known for fear of cen- 
sure for his want of observation in not detecting it in time 
to apply the proper remedies. This would be a most rep- 
rehensible conduct, and, when detected, should be met with 
no measured terms of disapprobation by every right-mind- 
ed and truly philanthropic member of the profession : nev- 
er allow one error to be covered up by the committal of 
another, and thereby deprive those who are- alike inex- 
perienced from the practical benefits which they might de- 
rive from a knowledge of the. misfortunes of the other. 

When the powers of the womb are not prostrated by long 
continued and unaided efforts for the expulsion of the child, 
and strong, healthy and vigorous action takes place, accom- 
panied with an immediate and equal contraction of all its 
parts, then all danger is happily at an end, and we may re- 
joice in the entire safety of our patient. I have never known 
a case of troublesome hemorrhage where the Supporter was 
used, either in my own practice, or that of any other phy- 
sician ; and I have taken pains to inquire particularly in re- 
ference to this matter, of those who have made the most 
extensive use of it. 

The beneficial effects of the Supporter in these respects 
are so nearly self-evident, that it seems almost like an in> 



SUPPORTER. 125 

position on the good sense of one who has been fairly ini- 
tiated into the science and art of obstetrics to undrtake to 
prove it by other means than the plain principles upon which 
the Instrument operates. From the very nature of the op- 
eration of the Supporter, taking into consideration the in- 
creased power which it affords to the voluntary muscles, it 
must be obvious to every person who has the slightest ac- 
quaintance with the mechanism and organs by which the 
birih of a child is effected, that in proportion as you increase 
the efficient power of that division of labor which is under 
the power of volition, that in the same proportion you re- 
lieve from labor the organic or involuntary agents that have 
a-share in this work. The fact is, there is a certain amount 
of labor, (and most woful hard labor too,) to be done by 
the two sets of agents appointed by the Almighty to per- 
form the work : if it is all thrown upon one set, of course 
they must perform it ; but, being contrary to the original 
design, it becomes unnatural labor for those parts, — the con- 
sequence is, an undue exhaustion and prostration of those 
parts. Whereas, if the labor is equally divided, agreeably 
to the design of Omnipotent Wisdom, each part will be 
competent to the task, and able to perform it without pro- 
ducing that degree of prostration that amounts to a tempora- 
ry suspension of the vitality of the part, and consequently 
an incapacity to promote any further action. This equality 
in the division of the labor for the two systems to perform, 
which is attributable to the use and effects of the Suppor- 
ter, enables the whole to go through its own portion of the 
labor with very little prostration of strength, and of course 
leaves it more vitality and contractile power, w r hich soon 
enables it to recover the natural size of the organ in an un- 
impregnated state, and the danger is less and the recovery, 
more rapid in the same ratio exactly. 



116 OBSTETRICAL 

There is another clanger, though not so frequent, but 
more disastrous in its consequences, which the Supporter 
would have a tendency to remove, if not entirely, to a very 
great extent : I allude to a rupture of the womb during la- 
bor, which is usually a most fatal accident. Happily, how- . 
ever, for the condition of poor suffering females, this is an 
accident of rather rare occurrence ; but when it does hap- 
pen, it is awful in the extreme, and every precaution ha- 
ving the most remote probability of preventing the accident, 
should be seized upon with avidity, and applied in a man- 
ner best calculated to give it full force and effect to accom- 
plish that object. If the rapture is a consequence of a dis- 
ease of the uterus, or from any cause the tendency of which 
is to destroy the strength or elasticity of the muscular fibre, 
or the fibre itself, probably no precaution v i bin the reach of 
a human arm could prevent it. But when he accident hap- 
pens in consequence of an undue exertion o tie womb to ex- 
pel its contents, having all or nearly all the labor thrown upon 
it for the want of proper means to bring in As aid the con- 
tractile power of the abdominal and resj itory muscles, 
then the Supporter is exactly the thine; it is wanted to 
supply the deficiency, and to prevent the o currence of this 
ter.ible and fatal disaster. 

The effect of the Supporter in these cases would be, to 
equalize the labor among all the natural pa s concerned in 
it, and, by so doing, relieve the womb from its almost un- 
earthty struggles, which are sometimes enough to break 
through bars of brass and tripple steel, and through the 
restoration of this equilibrium of action, save the lives of 
both mother and child. Not only this, but the manner in 
which the direction of the head may be controlled by the 
Supporter, as I have heretofore describ; d 3 which enables 
the accoucheur to prevent a lodgement of the head on the 



SUPPORTER. 117 

pubis or the sacuum ; or if the obliquity in the lineof di- 
rection is not sufficient to effect an entire lodgement on ei- 
ther of these points, the head may be prevented from pres- 
sing hard upon them — thereby requiring a much greater 
amount of contractile force from the womb to propel it for- 
ward.. Either of these accidents might very much endan- 
ger a rupture of the womb, which would probably be the 
death of both mother and child, and may with great ease be 
prevented , with a little tact in the use of the Obstetrical 
Supporter. 

Probably one great cause of a rupture of the womb ari- 
ses from its being pressed with great violence while in a dis- 
tended and attenuated state, and every fibre strained to its 
utmost extent of endurance by a powerful contraction be- 
tween the head of the child and the sharp angle of the linea 
clio-peitinea which is sometimes unusually sharp. All this 
danger may be prevented by a careful and skillful adapta- 
tion cf the head' of the child to the axis of the pelvis ; 
and should the calamity happen through a want of these pre- 
cautions by the one who had the charge of the female in 
this situation, he should be put where the disaster would 
not be repeated through his ignorance and want of skill. 

I have a word to say in this place, which ought to have 
been said in another place while speaking of a front pad, 
which has been proposed to be attached to the Obstetrical 
Supporter, to press directly over the region of the womb. 
Now there can be no doubt in the mind of anyone capable 
of comprehending the subject, that a pressure made in this 
manner on the womb, while in a state of violent contraction, 
would be one of the most fruitful causes of rupture that has 
ever had an agency in the production of that most dreadful 
casualty. 

There is still another benefit to be derived from the Sup,- 



118 OBSTETRICAL 

porter : it will have a direct and most decided tendency to 
prevent that frequent, troublesome, and sometimes even fa-, 
tal difficulty, called prolapsus uteri. So far as my own ob- 
servation goes, in reference to the cause of this difficulty, I 
think I can say that by far the greatest number of cases 
that I have treated might have been referred back, direct- 
ly or indirectly, for its cause, to a long, tedious and protrac- 
ted labor, where the whole burthen of that most terrible 
and fatiguing process has been thrown upon the uterus to 
perform almost entirely alone. The same thing happens 
here as in the case previously treated upon : there is no 
balance of power maintained, and no equality in the distri- 
bution of the labor among those parts which were designed 
by nature to co-operate in harmony together, in order to ac- 
complish with safety to all the parts concerned, that great 
work to which we have so frequently referred. Probably 
no one who has ever witnessed the progress and comple- 
tion of this labor would hesitate to declare without fear of 
contradiction, that when the labor was divided among the 
different parts designed to bear a portion of its burthen, 
with the most scrupulous care in regard to the equality of 
the distribution, that there was still enough in all conscience 
for each one to perform. 

It is in those cases where there is a great inequality in 
the distribution of the labor, that the womb becomes so 
much fatigued and worn out by an almost preternatural ex- 
ertion, and the ligaments of the womb are kept so long and 
so violently on the stretch, that their contractile power is 
not only prostrated, but almost entirely destroyed — so much 
so, that they remain in a flaccid and debilitated state for a 
great length of time. The same difficulty operates upon 
the foundation on which the womb rests that has already de- 
stroyed its suspensory power, so that the support is lost 



SIJTPORiEn. 119 

from above and beneath, and, of course, its gravity must 
carry it downwards : this is a prolapsus uteri, in some one 
of the stages in which authors describe it, which depends 
upon the extent it has fallen. After the female has waited 
as she believes a sufficient time from her accouchment for 
a recovery from its effects, she makes the attempt to walk 
about, and with a great pain in her back and side, a gene- 
ral feeling of lassitude and low spirits, accompanied with 
a seeming inability to raise her limbs from the floor, she 
drags herself around, an object of pity to all w r ho can ap- 
preciate the misery she endures. As soon as the female 
places herself in an erect position, under these circumstan- 
ces, and the gravity of the uterus is brought to bear on the 
enfeebled and debilitated ligaments, instead of holding it by 
a healthy and tonic contraction, they relax at once, and al- 
low the whole superincumbent weight to press upon the 
vagina, which in a healthy state affords a very great sup- 
port ; but from the general relaxation of all these parts, 
that now gives way, and a complete prolapsus uteri is the 
result of all these failures. 

I am aware that many writers on this subject refer the 
great majority of cases of prolapsus to leucorrhwa as a cause ; 
but I must beg leave to dissent from tbat opinion. That 
lucorrhcea accompanies a large majority of the cases of pro- 
lapsus, I have no doubt ; and that it accompanies it more 
frequently as an effect than a cause, I am equally certain. 

If I am correct in my views in regard to the cause of 
this difficulty, that is, throwing too great a proportion of 
the labor on the uterus, to perform alone, it will then fol- 
low as a necessary result, that if the cause be removed, 
the effects will cease to trouble us. It certainly cannot be 
thought unreasonable to say, that it is by far the most com- 
mendable course to use all proper means to prevent this 



ISO OBSTETRICAL 

disease, than to pursue a practice well calculated to produce 
it, and, when produced, use a remedy worse than useless 
for its cute. 

We now offer our Supporter to the profession, and thro' 
them to the poor sufferers, as an instrument that is exceed- 
ingly well calculated to remove this cause. The manner 
in which it will equalize the labor among the voluntary 
and involuntary parts, and thestrong L vigorous and healthy 
state in which it leaves the uterus, I have already com- 
mented upon, and shall not enlarge ur.cn again here. 

6th. That the mental effect produced by the Instrument 
is worth everything to the patient: and in speaking on this 
subject I can say as did Paul when he appeared before 
Agrippa. Hhe said, " I am thankful, O king, that I am 
permitted to speak before thee this day, touching those 
things whereof I am accused ; for I know thee to be ex- 
pert in all the laws, customs and usages of the Jews"': that 
is to say, he was thankful that the Judge, before whom he 
was to deliver his plea of justification, was one that could 
comprehend the depth and force of the arguments w T hich he 
was about to put forth in his own behalf. So it is with my- 
self when I address my professional friends on the effects of 
mental emotions. I. too, feel thankful that they can under- 
stand the force and appreciate the truth of my arguments. 
It is rather a popular notion that these mental emotions, op- 
erations and influences are trifles light as air, and are not 
worth the serious attention of any person to remedy, or 
prevent them when they spring from a wrong source, and 
follow a wrong channel. But the physician who is also 
a metaphysician, or, at least, sufficiently so to comprehend 
the phenomena which result from the connection of mind 
with matter, will from daily observation, become very 
competent and expert to judge of the wonderful influence 



SUPPORTER. 121 

which the mental exerts, and frequently for a long time 
maintains, over the corporeal system. 

I presume there is no experienced or practical accouch- 
eur that has not had frequent occasions, and many times too 
frequent for his own comfort, of witnessing the bad effects 
of the depressing passions, such as fear, despondency, and 
the like, which operate to clog the various wheels in hu- 
man machinery; and especially those females of delicate con- 
stitutions and finely attuned nervous systems. They cannot 
control their feelings; nor will anyone qualified to judge of 
the mutual effects of mind and matter, or sufficiently ac- 
quainted with to be capable of discriminating between the 
various constitutions and temperaments with which they 
will so frequently meet, expect them to do so. God has 
not furnished them, with materials to fortify against the ra- 
vages and inroads of injurious mental excitements, howev- 
er strong the desire may be. They cannot rise above the 
depressing and injurious effects of these mental emotions 
on the contractile power of the whole muscular system. — - 
These effects follow the operation of the cause, when it is 
allowed to exist, as necessarily and as certainly as a sick- 
ness of the stomach follows the administration of an emet- 
ic. Hence, our pity and commiseration may and ought to 
be excited in their behalf; but we never should allow our 
patience to be thrown from its equilibrium in conse- 
quence of our plans being thwarted by these causes* 

Who, among us all, have not witnessed more times than 
one, the total suspension of all operations, almost as com- 
pletely as if the patient had been visited With a shock of 
total paralysis,from the seemingly small cause of disappoint- 
ment in not being able to procure the attendance of her ' 
own favorite physician ? Then, hour after hour may elaps* 
before the inroads of these mental innovations can De re* 

k 



OBSTETRICAL 

paired, though met in the face and eyes by the exercise of 
all the tact and skill that the most expert manager can call 
to his aid. For this reason, I have alwa}^s been averse to 
attending cases in obstetrical practice where another * phy- 
sician was sent for before myself; not fFom any chagrin or 
jealousy because another one was preferred before me, but 
because I feared that some unpleasant consequence might 
be the result of the disappointment to the patient ; espe- 
cially if I know her to be one of those temperaments that 
will break over the restraints of the judgment, and run wild 
w T ith the imagination over the extended prairie of thought, 
gathering flowers only from those plants of a noisome and 
narcotic odor, the effects of which will bring up the gloomy 
shades of death before the mind's eye, and spread out the 
landscape of despair to gaze upon. In these cases, the rose 
and the lily may be tendered to them in vain — the medium 
through which they view things is smoked and bleared — 
the consequence is, the better appears the worse, and the 
worse the better. 

The time that has been lost, both to patient and physi- 
cian, the sufferings and tortures endured by poor unfortu- 
nate females who are constitutionally feeble, both in mus- 
cle and in nerve, and consequently full of fears, doubts and 
desponding feelings that arise in dismal clouds before her, 
from the fact that she knows her own inability through the 
delinquency of those physical powers to perform that im- 
portant work that lies before her and must be done, and 
the number of infant lives that have been lost by the un- 
reasonable procrastination of that much-desired moment to 
every poor, worn and disconsolate parturient female, i e., 
the end of their labor, never can be computed or compre- 
hended by any living man. Nothing short of the all-seeing 
eye that views the past as the present, can realize its mag- 



SUPPORTER. 123 

aitude. But the experience of eaeh individual will teach. 
him that if the experience of evenj individuahxlio has prac- 
ticed the art of midwifery were consolidated together, or 
spread out on one great chart before them, that the result 
would be most shocking to every philanthropic heart, and 
perfectly astounding to the most careless beholder. 

Now, over all this arid and desolate landscape, where 
sorrow and misery sit brooding like the boding owl over the 
devoted city of the plain, and while standing aghast in the 
midst of this Golgotha, where pyramids of human bones 
might be scraped together, must we sit down in despair and 
say, there is no remedy ! Is there no gleam of light ema- 
nating from the soul-cheering lamp of hope, to shed its 
bright beams on these cheerless regions where the sombre 
cloud of despair has cast its gloomy shadow o'er all the 
land ? Is there no balm left in Gilead, and is there no phy- 
sician there ? I say there is, and have tendered its services 
to the world. 

If fear and its attendant depressing passions are the cause 
of all these woes and ills of life, then if we remove the fear 
we abstract the cause : if we annihilate the cause, I need 
not add that we effect the cure ; and allow me to add, in 
all humility, it is a cure that the Genius of remedies might 
have been proud of. There is something peculiar and al- 
most wonderful about our Supporter to dispel fear and in- 
spire hope. It is like the coat of mail to the stout-hearted 
soldier, whose implicit confidence is reposed in it for the 
preservation of his life. I have never known or heard of a 
female, while using the Supporter, to be fearful, despond- 
ing, or doubtful of her ability to go through with the labor 
before her with certainty and success. The fact is, they 
feel themselves held and supported, in every place where 
support \B required ? in such a manner that they cannot mis- 



124 OBSTETRICAL 

take the great and certain utilityof the agent which imparts 
this support ; and it unavoidably inspires them with a soul- 
cheering certainty that they will be able to outride the 
storm of suffering and danger, and land triumphantly in the 
haven of safety and rest. And you may well suppose that 
the person who has passed through, on former occasions, a 
long, lingering, cheerless and desponding labor, can, in a 
most intelligible manner, appreciate these great and life- 
giving benefits. 

These are the effects and the legitimate results ^vowing 
out of a fair and well-timed use of our Supporter, and those 
who are disposed to doubt it I hope will remember the fate 
of unbelievers, and ponder well on the course they mark 
out for themselves, and beware how they incur the penalty 
annexed to their gratuitous folly and unbelief. 

And I would inquire, is there one among all the nume- 
rous intelligences of God's creation, who has ever experi- 
enced the transition from a gloomy, fearful and foreboding 
despair, to a firm, rational and well-grounded hope of suc- 
cess, that would not range this wide world over, from the 
icy regions of the north to the eternal snows of the south, 
to procure an agent which could impart this heaven-sent 
fruition ? A sudden passage from one of these conditions 
to the other is a fullness that we cannot comprehend how 
it can be improved even by the bliss of heaven itself. 

These are not the ephemeral and evanescent seribblings 
of an excited moment, or an over-heated brain, to accom- 
plish a selfish purpose, or eulogize an offspring ; but they 
are truths, and truths of momentous consequence. They 
must and will shine out to illuminate this earth, and cheer 
the heart of many a sorrow- stricken female. It is in vain to 
raise the puny arm of mortality to prevent them : as well 
might you interpose the gossamer to shut out the rays of 



SUPPORTER. 125 

heaven's bright luminary, and eclipse this earth in total 
darkness. 

Let us then vie with each other in our exertions to send 
broad-cast, all over the earth, an agent that will cast out 
fear and inspire hope among that division of our lace to 
whom, under God, we are most directly indebted for our 
own existence ; and ere we pause from our labors, let us 
feel sure that none are in want of this blessing from a lack 
of our exertions. Then may we rest our head on our pil- 
low, and say and believe that we have not lived in vain. 

The stimulus of hope is one of the safest, the most de- 
lightful, the most soul-exhilarating remedies that ever was 
administered to mortal man. It is probably not of terres- 
trial origin, buUhas its source from that Fountain that sup- 
plies " every good and perfect gift." It is a lamp that 
lights up the pathway of the poor suffering pilgrim whose 
journey is onward through the shoals and quicksands of 
this wicked world. This stimulus of hope is always safe, 
but does not intoxicate : herein lies one very desirable 
property of the remedy — it is perfectly safe at all times 1 
and under all circumstances, whether w r eak or strong. The 
beggar may obtain it — the rich man may not be able to buy 
it. This potent charm may always be administered with 
an entire certainty that no bad effects will result from its 
administration ; and when it is tendered by a soothing and 
friendly hand, accompanied by the good wishes of those 
who administer it, how the languishing soul will drink it 
down ! Nothing can be more grateful to the care-worn 
spirit that is seeking for a resting-place or green spot where- 
on it may repos3 and be shielded from the ills of this life. 

The use of our Supporter affords all these benefi's of 
hope and confidence, and by every pain through which the 
suffering fema!e passes, she is satisfied that something has 

k2 



126 OBSTETRICAL 

been accomplished. From the success of every effort she 
is inspired with confidence to make another ; and now so 
great is the progress of the labor that the patient becomes 
satisfied, beyond a lingering doubt, that her exertions are 
being attended with the most complete and satisfactory suc- 
cess ; and soon she begins to indulge a hope that every ef- 
fort which she makes will be the last that w T ill be necessa- 
ry to free her from her sufferings and allow her to repose 
under the watchful and soothing care of her friends ; and 
mast happy am 1 to say, that it is very seldom the case that 
it proves to be a hope deferred. 

This closes what I have to say on the beneficial effects 
of the Supporter. Much more might be said : in fact, it 
is difficult to say too much in its favor, or to praise it high- 
er than it deserves ; but enough has probably been said to 
induce my readers to make a trial of it, and a full and fair 
trial is all that I ask to insure its unbounded success. I 
now leave it in the hands of my professional friends : they 
are competent to judge of its power to do good in the world, 
and to relieve those who most of all have stood in need of 
it for a great length of time ; and I feel confident that no 
true philanthropist, who is in possession of a knowledge of 
the great benefits that may be derived from its introduction 
and use, will ever* lay a straw in the way of its onward 
course, until it is within the reach of all who may require 
its aid. 

A fair trial is all we ask of any one ; and when this is 
done under circumstances to make it a fair one, and it does 
rot meet the expectation or come up to the recommenda- 
tion I have given it, then throw it aside in the waste places 
and let it moulder away with the useless and unused things 
of this world. But I can most solemnly assure the world 
at large, that it is no humbug ; nor is it anything originating 



SUPPORTER. 127 

in that direction. It is well known to all the world who 
know me, that I am not a vender of humbugs. 1 have uni- 
formly opposed all the leading impositions of the day that 
crossed my path, and those that have moored themselves 
within range of my guns, with all the energy and ability 
that God has given me ; and what little I have been able 
to add to it, has been freely thrown into the same side of 
the balance. This has been done, many times, w r ith a bold- 
ness and determination of purpose that has injured my bu- 
siness, and sometimes to a considerable extent ; but I have 
taken what I believed to be duty for my guide, and made my 
opposition to humbugs and impositions without reference 
to loss or gain. I have neither fellowship nor partnership 
with the hordes of that genus of spirits that escaped from 
the disaster when the swine ran furiously into the sea and 
were drowned — who have since been made tangible bodies 
and are now strolling the country under the names of 
4 Quacks' and ' Impostors' — who are cheating the gallows 
out of that on which it has a fair and undoubted claim — 
who are trespassing on the legal rights of the people every 
step they take that is not toward the state prison — and who 
are flooding the land from the arctic to the antarctic regions 
with their nostrums, panaceas, and all other aerial wonder- 
working curatives, and their pigmies on elephants' legs, 
boasting of their semi-almighty power to trample diseases of 
all kinds under their feet with the same ease that the jack- 
ass did the chickens, and it is usually done with about the 
same amount of skill and intelligence. All their patent rem- 
edies are usually put a little ahead of the fruit from the ori- 
ginal tree of life, and of course must act by charms, incan- 
tations and legerdemain ; for, according to their own show- 
ing, they can act on no known or natural principles. The 
venders, boasting at the same time of their supernatural 



128 OBSTETRICAL 

powers and inspirations in the healing art, having received 
their pretended skill by imbibition, substituting impu- 
dence for knowledge, they shrink not at telling the most 
barefaced and outrageous falsehood that their great tutor 
and schoolmaster, the Devil, has ever instructed them in. 
True, their remedies are generally effectual ; for they usu- 
ally kill disease and patient with the same stroke of their 
wand. No doubt but these perambulating siroccos destroy 
more lives than the cholera, the plague, and all the other 
sweeping epidemics that have gone abroad among us appa- 
rently to make desolate the face of the earth. Epidemics 
are usually periodical, and occur only at long intervals ; but 
these scoundrels, like the virus of some unseen cyptogamia, 
are always at their work of destruction. Sometimes, when 
I look abroad upon their works and the workers, I think 
as the old bachelor did when the school-boys gathered 
around him, tangled his legs, and threw him down. He 
then arose in his w T rath and frowned most portentously on 
the boys, and exclaimed, " We are in great want of a pes- 
tilence \P 

I do not wish to be understood as boasting of my know- 
ledge, or scientific attainments. I never pretended to know 
but little ; and, in what I have said, I only mean to be un- 
derstood that I do not make, unfounded pretensions to a 
knowledge of things, of the nature of which I am entirely 
ignorant. I know very well that I have said some large 
things of our Supporter ; and I also believe that I have ex- 
plained them upon natural and philosophical principles. — 
We have made no pretensions to a special revelation, nor 
have we called to our aid the operation of supernatural 
causes. I again repeat, that we have got up this Instru- 
ment with care and deliberation. Commencing with a small 
and somewhat rude beginning, I made trial of its effects, 



SUPPORTER. 129 

watching with all the acuteness that I was master of the 
benefits it produced — endeavoring, at the same time, to as- 
certain all the wants of nature that were not supplied. As 
I from time to time discovered these wants, I endeavored 
to supply them, with the best means that the ingenuity of 
us both could invent ; and when, as I believe, from repeat- 
ed trials and close and unwearied observation, I had sup- 
plied all the calls of nature, 1 stopped — believing that any- 
thing further would have a tendency to complicate the In* 
strument, and injure its effects, thereby defeating the ends 
I had so ardently desired to accomplish. 

And I believe that it may be said without boasting, that 
I am not exactly a novice in that department of our pro- 
fession which pertains to the art of obstetrics. I hope 
my friends will excuse a relation I am about to give, 
which might, under some circumstances, appear like a 
pedantic boast ; but I believe my design is laudable, for I 
make the statement not so much in pride as in thankfulness 
to God for his blessings on the feeble means which I have 
been enabled to put forth for the preservation of the liyes 
of my fellow-beings. 

In almost seventeen years 1 practice, I have never lost a 
solitary patient in child-birth that has been under my care, 
nor of any disease immediately connected with it. To 
those who are acquainted with me, I need not say that it 
is not because I have done nothing in this branch of my 
profession. To those who are not acquainted with me, I 
will only say, that I have probably done as much as any 
other country practitioner of my age. If any doubts are 
entertained of the veracity of these statements, they may 
be easily satisfied on all these matters by a correspondence 
with those who know me well. All my field of operations 
in my professional career has been in Essex and Clinton 
counties, in the state of New York. 



130 OF .riTRICAL 

I now leave this subject to be enlarged upon by wiser 
heads, and embellished by more able pens than mine. If 
this Instrument shall prove as beneficial as I have anticipa- 
ted it will, to that portion of my fellow-beings to whom I 
am more immediately indebted for my existence, and to 
whose fostering care I owe the preservation and sustenance 
of my helpless, and infantile years, then I shall consider all 
my toil and labor, both mental and corporeal, most amply 
rewarded; and the good wishes and fervent prayers of those 
kind-hearted females for my future success in all laudable 
designs, is all the monument of fame that I aspire to. 



Explanation of the Plates. 

Plate 1. 

Figure 1 is a perspective view ; [A] Is a pad to hold 
and support the back and apply a counter pressure to that 
made by the head of the child ; [BB] Is a strap passing 
through two loops on the back pad, having- a buckle [b] 
on each end, buckling back into the strap towards the back 
pad, enabling the accoucheur to adapt it to the length of 
the thigh of any person w T ith great facility ; it also forms 
two large loops for the knees, with two straps passing un- 
der the feet to prevent the possibility of the loops of the 
main strap slipping from the knee. 

Fig. 2 Is a back pad. [A] Shows the back of the pad, 
also its true shape ; [B] Shows the main strap as it passes 
through the loops on the back pad. 

Fig. 3 Is a moveable knee pad; [C] Is the pad itself; 
[B] Is the main strap passing through two loops on which 



guPPORTEtl. 



131 



the knee pad slides ; [E] Is a narrow strap, going up the 
thigh, to which the handles are attached. 

Fig. 4 Is one of the handles. [D] Is the part of the 
handle to he grasped with the hand ; [E] The strap that 
passes through the loops of the knee pad, then passes up 
the thigh on each side, to which the handle is attached ; 
[C] Is the knee pad, 




132 



SUPPORTER, 



Fig. 



Plate 2. 
5 Shows the Instrument in use. [A] Shows thfe 
place of the back pad ; [BBB] shows the different situa- 
tions of the main strap when the Instrument is applied ; 
[D D] shows the two handles as they lay transversely 
across the thighs ; [E E] are two straps to which the 
handles are attached ;. [C CJ shows the situation of the 
knee pads ; [F F] shows the two straps that pass under 
the feet to prevent the main strap from slipping over, the 
knee. 



Tiai S 









LIBRARY OF CONGRESS 

021 062 538 



